Prediction of recovery of left ventricular dysfunction after acute myocardial infarction: Comparison between Tc-99m-sestamibi cardiac tomography and low-dose dobutamine echocardiography
Prediction of recovery of left ventricular dysfunction after acute myocardial infarction: Comparison between Tc-99m-sestamibi cardiac tomography and low-dose dobutamine echocardiography(294 views) Spinelli L, Petretta M, Cuocolo A, Nicolai E, Acampa W, Vicario L, Bonaduce D
Affiliations: Ctro. per la Med. Nucleare del CNR, Università Federico II, via Pansini 5-80131, Napoli, Italy
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Wackers, F. J. Th., Radionuclide detection of myocardial ischemia and myocardial viability: Is the glass half empty or half full? (1996) J Am Coll Cardiol., 27, pp. 1598-1600
Bonow, R. O., Dilsizian, V., Thallium-201 and technetium-99m-sestamibi for assessing viable myocardium (1992) J Nucl Med., 33, pp. 815-818
Maes, A. F., Borgers, M., Flameng, W., Assessment of myocardial viability in chronic coronary artery disease using technetium-99m sestamibi SPECT: Correlation with histologic and positron emission tomographic studies and functional follow-up (1997) J Am Coll Cardiol., 29, pp. 62-68
Sawada, S. G., Alman, K. C., Muzik, O., Positron emission tomography detects evidence of viability in rest technetium-99m-sestamibi defects (1994) J Am Coll Cardiol., 23, pp. 92-98
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Schwarz, E. R., Schaper, J., Vom Dahl, J., Myocyte degeneration and cell death in hibernating human myocardium (1996) J Am Coll Cardiol., 27, pp. 1577-1585
Vanovershelde, J. J., D'hondt, A., Marwick, T., Head-to-head comparison of exercise-redistribution-reinjection thallium single-photon emission computed tomography and low dose dobutamine echocardiography for prediction reversibility of chronic left ventricular dysfunction (1996) J Am Coll Cardiol., 28, pp. 432-442
Prediction of recovery of left ventricular dysfunction after acute myocardial infarction: Comparison between Tc-99m-sestamibi cardiac tomography and low-dose dobutamine echocardiography
The aim of this study was to evaluate the role of Tc-99m-sestamibi cardiac imaging and dobutamine echocardiography in detecting myocardial viability early after acute myocardial infarction. Methods: Forty-nine patients (mean age 52 +/- 10 y) underwent coronary angiography, low-dose dobutamine echocardiography, radionuclide angiography and rest Tc-99m-sestamibi imaging within 10 d after myocardial infarction. Of these patients, 19 were revascularized and 30 were treated medically. Resting echocardiogram and radionuclide angiography were repeated 8 mo later to evaluate segmental functional recovery and changes in left ventricular (LV) ejection fraction, respectively. Results: In revascularized patients, 61 of 108 akinetic or dyskinetic segments showed functional recovery. In these patients, sensitivity in predicting segmental functional recovery was 87% for sestamibi imaging and 66% for dobutamine echocardiography (P < 0.001), whereas specificity and accuracy were comparable. Sestamibi activity (greater than or equal to 55% of peak) was the strongest predictor of segmental functional recovery (P < 0.001) and of LV ejection fraction improvement greater than or equal to 5% (P < 0.01) after revascularization. In medically treated patients, 60 of 149 akinetic or dyskinetic segments showed functional recovery. In these patients, the majority (94%) of segments with contractile reserve on dobutamine were viable on sestamibi imaging and 86% of them improved function at follow-up. Functional recovery was poor in segments without contractile reserve either with (38%) or without (62%) preserved sestamibi uptake. Inotropic response was the best predictor of segmental (P < 0.001) and global (P < 0.01) LV functional improvement in medically treated patients. Conclusion: Dobutamine echocardiography predicts spontaneous functional recovery after acute myocardial infarction. However, sestamibi imaging is useful to identify patients with dysfunctional myocardium without contractile reserve who may benefit from coronary revascularization.
Prediction of recovery of left ventricular dysfunction after acute myocardial infarction: Comparison between Tc-99m-sestamibi cardiac tomography and low-dose dobutamine echocardiography
Prediction of recovery of left ventricular dysfunction after acute myocardial infarction: Comparison between Tc-99m-sestamibi cardiac tomography and low-dose dobutamine echocardiography
Hesse B, Tagil K, Cuocolo A, Anagnostopoulos C, Bardies M, Bax J, Bengel F, Busemann Sokole E, Davies G, Dondi M, Edenbrandt L, Franken P, Kjaer A, Knuuti J, Lassmann M, Ljungberg M, Marcassa C, Marie PY, Mckiddie F, O'connor M, Prvuolovich E, Underwood R * 3. 0 T perfusion MR imaging(731 views) Rivista Di Neuroradiologia (ISSN: 1120-9976), 2004; 17(6): 807-812. Impact Factor:0.023 ViewExport to BibTeXExport to EndNote