• Classic Concept
– Myocardial dysfunction due to temporary
– Dependent on perfusion reserve
• New Concept
– Canty JM et al. JNC 2000;7:509-527
– Two kinds: acute / chronic (repetitive)
– Preliminary state to ‘hibernation’
– A different phase on a continuum of
coronary artery disease
• Induced by acute stress
– Either physical or psychologic
– Variable duration
• Usually prolonged over from several hours to a
couple of days
• How about on iatrogenic stress?
• “Transient prolonged stunning induced
by dipyridamole and shown on 1- and 24-
hour poststress 99m
Tc-MIBI gated SPECT”
– Lee DS et al.
– JNM 2000;41:27-35
– One-hour poststress myocardial motion
shows stunning effect, compared to wall
motion at 24-hour after stress
• Gated myocardial SPECT in patient with
IHSS showed decreased motion and
thickening at stress image while normal
motion and thickening at rest.
• It can be stunning effect of
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