Sestamibi imaging and echocardiography: a combined approach to myocardial infarction

The resting relationship of MIBI segmental uptake to regional wall motion has been studied in 30 patients with postinfarction wall motion abnormalities. The purpose of this study was to verify whether an integrated approach using Sestamibi (MIBI) imaging (perfusion analysis) combined with echocardiography (ECHO) (wall motion analysis) could present an additive value to differentiate infarcted from viable myocardial areas with respect to MIBI imaging alone. The same 11 segments model for left ventricle was used to compare segmental wall motion scores versus segmental uptake scores using a chi 2 analysis. The global score frequency rates for MIBI and ECHO were examined and a subsequent comparative analysis score versus score on each segment was performed. Our data, based on a chi 2 analysis, indicated that MIBI imaging overestimates the effective area of necrosis, underestimating, furthermore, hypoperfused but non-necrotic myocardium. We can conclude that an integrated approach based on both segmental perfusion and wall motion analysis, seems to be clinically suitable for a correct evaluation of infarcted patients, especially in view of revascularization procedures, providing an additive value in discriminative capacity, with respect to MIBI scintigraphic analysis alone.