Relationship between contractile reserve, TI-201 uptake, and collateral angiographic circulation in collateral-dependent myocardium: Implications regarding the evaluation of myocardial viability
Relationship between contractile reserve, TI-201 uptake, and collateral angiographic circulation in collateral-dependent myocardium: Implications regarding the evaluation of myocardial viability(497 views) Piscione F, De Luca G, Perrone-filardi P, Prastaro M, Pace L, Galasso G, Marrazzo G, Salvatore M, Chiariello M
Division of Cardiology, Federico II University, 80131 Naple, Italy
Institute of Nuclear Medicine, Federico II University, Naples 80131, Italy
References: Braunwald, E., Ritherford, J.D., Reversible ischemic left ventricular dysfunction: Evidence for the "hibernating myocardium" (1986) J. Am. Coll. Cardiol., 8, pp. 1467-147
Rahimtoola, S.H., The hibernating myocardium (1989) Am. Heart J., 117, pp. 211-221
Dilsizian, V., Bonow, R.O., Current diagnostic techniques os assessing viability in patients with hibernating and stunning myocardium (1993) Circulation, 87, pp. 1-20
Tillish, J., Brunken, R., Marshall, R., Schwaiger, M., Mandelkern, M., Phelps, M., Reversibility of cardiac wall-motion abnormalities predicted by positron tomography (1986) N. Engl. J. Med., 314, pp. 884-888
Lee, K.S., Marwick, T.H., Cook, S.A., Go, R.T., Fix, J.S., James, K.B., Prognosis of patients with left ventricular dysfunction with and without viable myocardium after myocardial infarction: Relative efficacy of medical therapy and revascularization (1994) Circulation, 90, pp. 2687-2694
Bax, J.J., Poldermans, D., Elhendy, A., Cornel, J.H., Boersma, E., Rambaldi, R., Improvement of ventricular ejection fraction, heart failure symptoms and prognosis after revascularization in patients with chronic coronary artery disease and viable myocardium detected by dobutamine stress echocardiography (1999) J. Am. Coll. Cardiol., 34, pp. 163-169
Meluzin, J., Cerny, J., Frelich, M., Stetka, F., Spinarova, L., Popelova, J., Prognostic value of the amount of dysfunctional but viable myocardium in revascularized patients with coronary artery disease and left ventricular dysfunction (1998) J. Am. Coll. Cardiol., 32, pp. 912-920
Sabia, P.J., Powers, E.R., Jayaweera, A.R., Ragosta, M., Kaul, S., Functional significance of collateral blood flow in patients with recent acute myocardial infarction: A study using myocardial contrast echocardiography (1992) Circulation, 85, pp. 2082-2089
Kozman, H., Cook, J.M., Wiseman, A.H., Dann, R.H., Engelman, R.M., Presence of angiographic coronary collaterals predicts myocardial recovery after coronary bypass surgery in patients with severe left ventricular dysfunction (1998) Circulation, 98, pp. II57-II61
Gensini, G.G., Bruto da Costa, B.C., The coronary collateral circulation in living man (1969) Am. J. Cardiol., 24, pp. 393-400
Di Carli, M., Sherman, T., Khanna, S., Davidson, M., Rosksar, S., Hawkins, R., Myocardial viability in asynergic regions subtended by occluded coronary arteries: Relation to the status of collateral flow in patients with chronic coronary artery disease (1994) J. Coll. Cardiol., 23, pp. 860-868
Cohen, M.V., Coronary collaterals: Clinical and experimental observations (1985), pp. 1-91. , Mount Kisco (NY): FuturaUren, N.G., Melin, J.A., De Bruyne, B., Wijns, W., Baudhuin, T., Camici, P.G., Relation between myocardial blood flow and the severity of coronary artery stenosis (1994) N. Engl. J. Med., 330, pp. 1782-1788
Vanoverschelde, J.J., Wijns, W., Deprè, C., Essamri, B., Heyndricks, G.R., Borgers, M., Mechanisms of chronic regional postischemic dysfunction in human: New insight from the study of non infarcted collateral-dependent myocardium (1993) Circulation, 87, pp. 1512-1523
Sambuceti, G., Parodi, O., Giorgetti, A., Salvadori, P., Marzilli, M., Dabizzi, P., Microvascular dysfunction in collateral-dependent myocardium (1995) J. Am. Coll. Cardiol., 26, pp. 615-623
Rentrop, P.K., Cohen, M., Blanke, H., Philips, R.A., Changes in collateral filling immediately after controlled coronary artery occlusion by an angioplasty balloon in human subjects (1985) J. Am. Coll. Cardiol., 5, pp. 587-592
Perrone-Filardi, P., Pace, L., Prastaro, M., Piscione, F., Betocchi, S., Squame, F., Dobutamine echocardiography predicts improvement of hypoperfused dysfunctional myocardium after revascularization in patients with coronary artery disease (1995) Circulation, 91, pp. 2556-2565
Pace, L., Perrone-Filardi, P., Mainenti, P.P., Cuocolo, A., Vezzuto, P., Prastaro, M., Identification of viable myocardium in patients with chronic coronary artery disease using rest-redistribution thallium-201 tomography: Optimal imaging analysis (1998) J. Nucl. Med., 39, pp. 1869-1874
Schiller, N.B., Shah, P.M., Crawford, M., DeMaria, A., Devereaux, R., Feigembaum, H., Recommendation for quantitation of the left ventricle by two-dimensional echocardiography (1989) J. Am. Soc. Echocardiogr., 2, pp. 358-367
Norusis, M.J., SPSS for windows. Advanced statistics (1993), Release 6.0. Chicago: SPSS IncBarillà, F., De Vincentiis, G., Mangieri, E., Ciavolella, M., Pannitteri, G., Scopinaro, F., Recovery of contractility of viable myocardium during inotropic stimulation is not dependent on an increase of myocardial blood flow in the absence of collateral filling (1999) J. Am. Coil. Cardiol., 33, pp. 697-704
deFilippi, C.R., Willett, D.W.L., Irani, W.L., Eichhorn, E.J., Velasco, C.E., Grayburn, P.A., Comparison of myocardial contrast echocardiography and low-dose dobutamine stress echocardiography in predicting recovery of left ventricular function after coronary revascularization in chronic ischemic heart disease (1995) Circulation, 92, pp. 2863-2868
Qureshi, U., Nagueh, S.F., Afridi, I., Vaduganathan, P., Blaustein, A., Verani, S.M., Dobutamine echocardiography and quantitative rest-redistribution 201Tl tomography in myocardial hibernation. Relation of contractile reserve to 201Tl uptake and comparative prediction of recovery of function (1997) Circulation, 95, pp. 626-635
Severi, S., Underwood, R., Mohiaddin, R.H., Boyd, H., Paterni, M., Camici, G.P., Dobutamine stress: Effects on myocardial blood flow and wall motion (1995) J. Am. Coll. Cardiol., 26, pp. 1187-1195
Lee, H.H., Davila-Roman, V.G., Ludbrook, P.A., Courtois, M., Walsh, J.F., Delano, D.A., Dependency of contractile reserve on myocardial blood flow. Implications for the assessment of myocardial viability with dobutamine stress echocardiography (1997) Circulation, 96, pp. 2884-2891
Elsasser, A., Schlepper, M., Klovekorn, W.P., Cai, W., Zimmermann, R., Muller, K.D., Hibernating myocardium. An incomplete adaptation to ischemia (1997) Circulation, 96, pp. 2920-2931
Meza, M.F., Ramee, S., Collins, T., Stapleton, D., Milani, R.V., Murgo, J.P., Knowledge of perfusion and contractile reserve improves the predictive value of recovery of regional myocardial function postrevascularization. A study using the combination of myocardial contrast echocardiography and dobutamine echocardiography (1997) Circulation, 96, pp. 3459-3465
Cwajg, J.M., Cwajg, M., Nagueh, S.F., Zuo-Xiang, H., Qureshi, U., Olmos, L.I., End-diastolic wall thickness as a predictor of recovery of function in myocardial hibernation: Relation to rest-redistribution Tl-201 tomography and dobutamine, stress echocardiography (2000) J. Am. Coll. Cardiol., 35, pp. 1152-1161
Afridi, I., Kleiman, N.S., Raizner, A.E., Zoghbi, W.A., Dobutamine echocardiography in myocardial hibernation: Optimal dose and accuracy in predicting recovery of ventricular function following coronary angioplasty (1995) Circulation, 91, pp. 663-670
Panza, J.A., Dilsizian, V., Laurienzo, J.M., Curiel, R.V., Katsiyiannis, P.T., Relation between thallium uptake and contractile response to dobutamine. Implications regarding myocardial viability in patients with chronic coronary artery disease and left ventricular dysfunction (1995) Circulation, 91, pp. 990-998
Rahimtoola, S. H., The hibernating myocardium (1989) Am. Heart J., 117, pp. 211-221
Lee, K. S., Marwick, T. H., Cook, S. A., Go, R. T., Fix, J. S., James, K. B., Prognosis of patients with left ventricular dysfunction with and without viable myocardium after myocardial infarction: Relative efficacy of medical therapy and revascularization (1994) Circulation, 90, pp. 2687-2694
Bax, J. J., Poldermans, D., Elhendy, A., Cornel, J. H., Boersma, E., Rambaldi, R., Improvement of ventricular ejection fraction, heart failure symptoms and prognosis after revascularization in patients with chronic coronary artery disease and viable myocardium detected by dobutamine stress echocardiography (1999) J. Am. Coll. Cardiol., 34, pp. 163-169
Sabia, P. J., Powers, E. R., Jayaweera, A. R., Ragosta, M., Kaul, S., Functional significance of collateral blood flow in patients with recent acute myocardial infarction: A study using myocardial contrast echocardiography (1992) Circulation, 85, pp. 2082-2089
Gensini, G. G., Bruto da Costa, B. C., The coronary collateral circulation in living man (1969) Am. J. Cardiol., 24, pp. 393-400
Cohen, M. V., Coronary collaterals: Clinical and experimental observations (1985), pp. 1-91. , Mount Kisco (NY): FuturaUren, N. G., Melin, J. A., De Bruyne, B., Wijns, W., Baudhuin, T., Camici, P. G., Relation between myocardial blood flow and the severity of coronary artery stenosis (1994) N. Engl. J. Med., 330, pp. 1782-1788
Vanoverschelde, J. J., Wijns, W., Depr, C., Essamri, B., Heyndricks, G. R., Borgers, M., Mechanisms of chronic regional postischemic dysfunction in human: New insight from the study of non infarcted collateral-dependent myocardium (1993) Circulation, 87, pp. 1512-1523
Rentrop, P. K., Cohen, M., Blanke, H., Philips, R. A., Changes in collateral filling immediately after controlled coronary artery occlusion by an angioplasty balloon in human subjects (1985) J. Am. Coll. Cardiol., 5, pp. 587-592
Schiller, N. B., Shah, P. M., Crawford, M., DeMaria, A., Devereaux, R., Feigembaum, H., Recommendation for quantitation of the left ventricle by two-dimensional echocardiography (1989) J. Am. Soc. Echocardiogr., 2, pp. 358-367
Norusis, M. J., SPSS for windows. Advanced statistics (1993), Release 6. 0. Chicago: SPSS IncBarill, F., De Vincentiis, G., Mangieri, E., Ciavolella, M., Pannitteri, G., Scopinaro, F., Recovery of contractility of viable myocardium during inotropic stimulation is not dependent on an increase of myocardial blood flow in the absence of collateral filling (1999) J. Am. Coil. Cardiol., 33, pp. 697-704
deFilippi, C. R., Willett, D. W. L., Irani, W. L., Eichhorn, E. J., Velasco, C. E., Grayburn, P. A., Comparison of myocardial contrast echocardiography and low-dose dobutamine stress echocardiography in predicting recovery of left ventricular function after coronary revascularization in chronic ischemic heart disease (1995) Circulation, 92, pp. 2863-2868
Lee, H. H., Davila-Roman, V. G., Ludbrook, P. A., Courtois, M., Walsh, J. F., Delano, D. A., Dependency of contractile reserve on myocardial blood flow. Implications for the assessment of myocardial viability with dobutamine stress echocardiography (1997) Circulation, 96, pp. 2884-2891
Meza, M. F., Ramee, S., Collins, T., Stapleton, D., Milani, R. V., Murgo, J. P., Knowledge of perfusion and contractile reserve improves the predictive value of recovery of regional myocardial function postrevascularization. A study using the combination of myocardial contrast echocardiography and dobutamine echocardiography (1997) Circulation, 96, pp. 3459-3465
Cwajg, J. M., Cwajg, M., Nagueh, S. F., Zuo-Xiang, H., Qureshi, U., Olmos, L. I., End-diastolic wall thickness as a predictor of recovery of function in myocardial hibernation: Relation to rest-redistribution Tl-201 tomography and dobutamine, stress echocardiography (2000) J. Am. Coll. Cardiol., 35, pp. 1152-1161
Panza, J. A., Dilsizian, V., Laurienzo, J. M., Curiel, R. V., Katsiyiannis, P. T., Relation between thallium uptake and contractile response to dobutamine. Implications regarding myocardial viability in patients with chronic coronary artery disease and left ventricular dysfunction (1995) Circulation, 91, pp. 990-998
Relationship between contractile reserve, TI-201 uptake, and collateral angiographic circulation in collateral-dependent myocardium: Implications regarding the evaluation of myocardial viability
Background. The aim of this study was to compare collateral angiographic circulation (CC), thallium 201 single photon emission computed tomography (SPECT), low-dose dobutamine echocardiography (LDDE), and their combination in identifying viable myocardium beyond a chronic occlusion. Methods and results. We studied 33 consecutive patients with a chronic occluded coronary artery and regional ventricular dysfunction who underwent dobutamine infusion (5-10 μg · kg-1 · min-1),Tl-201 SPECT, and coronary revascularization (15 patients underwent coronary artery bypass grafting and 18 patients percutaneous transluminal coronary angioplasty). Echocardiography and Tl-201 SPECT at rest were repeated 90 ± 48 days after revascularization. For viability assessment, Tl-201 SPECT showed the best sensitivity and accuracy (77% and 72%, respectively) compared with LDDE (64% and 63%, respectively) and CC (74% and 55%, P < .05 vs Tl-201 SPECT). Specificity was significantly better for both Tl-201 SPECT (65%) and LDDE (62%) compared with collateral circulation (27%, P < .001 vs Tl-201 SPECT and LDDE). Furthermore, combined Tl-201 SPECT and LDDE data improved specificity (from 88% to 92%) and positive predictive power (from 75% to 78%) but not global accuracy. A direct relationship between the number of viable segments and global functional recovery after revascularization was found only in the case of Tl-201 SPECT (r = 0.48, P = .04). Conclusions. This study demonstrates that CC has a very low specificity in the evaluation of viability in collateral-dependent myocardium and that LDDE has a very low sensitivity, whereas Tl-201 SPECT is the most reliable method, particularly in akinetic segments, and optimally identifies patients who will mostly benefit from revascularization in terms of ventricular functional improvement. No additional advantages in terms of accuracy were found when Tl-201 SPECT and LDDE data were combined.
Relationship between contractile reserve, TI-201 uptake, and collateral angiographic circulation in collateral-dependent myocardium: Implications regarding the evaluation of myocardial viability
Relationship between contractile reserve, TI-201 uptake, and collateral angiographic circulation in collateral-dependent myocardium: Implications regarding the evaluation of myocardial viability