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[Myocardial contractility and viability. A radionuclide tomography study using technetium-99m labeled isonitriles]
G Tamosiunas1, J Castell, J Candell Riera
1Servico de Cardiología, Hospital General Universitari Vall d'Hebron, Barcelona.
Revista Espanola De Cardiologia
|July 1, 1995
Summary
Quantitative SPECT analysis reveals significant myocardial viability in akinetic and dyskinetic regions of patients with coronary artery disease, challenging visual assessment. This highlights the need for quantitative methods to accurately evaluate viable myocardium.
Area of Science:
- Cardiology
- Nuclear Medicine
- Medical Imaging
Background:
- Limited studies explore myocardial viability patterns and contractility in coronary artery disease (CAD).
- Accurate assessment of viable myocardium is crucial for guiding treatment decisions in CAD patients.
Purpose of the Study:
- To quantify viable and nonviable myocardium using 99m-technetium isonitriles SPECT.
- To correlate myocardial viability with left ventricular regional wall motion abnormalities in CAD.
Main Methods:
- Investigated 61 consecutive CAD patients.
- Utilized qualitative and quantitative analysis of 99mTc-isonitriles SPECT, compared with ventriculography.
- Defined viable myocardium as 40% or higher of peak uptake.
Main Results:
- 72% of regions had normal perfusion; 41% were ischemic; 19% had severe irreversible defects.
- Wall motion was normal in 72%, hypokinetic in 12%, and akinetic/dyskinetic in 16% of regions.
- Akinetic/dyskinetic regions showed significantly less viable myocardium (64.8%) compared to normokinetic (98.8%) and hypokinetic (86.1%) regions.
Conclusions:
- Positive viability criteria were found in 61% of akinetic/dyskinetic regions with severe irreversible defects.
- Visual assessment of 99mTc-MIBI SPECT underestimates viable myocardium.
- Quantitative SPECT analysis is essential for accurate myocardial viability evaluation.