| BMIPP imaging to improve the value of sestamibi scintigraphy for predicting functional outcome in severe chronic ischemic left ventricular dysfunction. | |
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MedLine Citation:
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PMID: 10492367 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Mismatching between beta-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) and perfusion accurately predicts functional outcome after acute myocardial infarction. The current investigation was aimed at evaluating the value of this method to predict the evolution of global function according to the applied treatment in patients with chronic ischemic heart disease. METHODS: Twenty patients with infarction and chronic left ventricular dysfunction were studied (median infarction age 12 wk, range 2 wk-15 y). Radionuclide angiography, two-dimensional echocardiography and BMIPP and gated sestamibi scintigraphy were performed with the patient at rest before and >6 mo after treatment (revascularization in 13 patients and conservative therapy in 7 patients). In 7 patients, radionuclide angiography was repeated after 1 y. RESULTS: On a patient basis, mismatching with BMIPP less than sestamibi was noted in 15 patients at baseline. Of these 15 patients, 11 had significant functional improvement at follow-up versus only 1 of the 5 patients with a matched decreased uptake. Hence, the combined sestamibi/BMIPP was 73% positive and 80% negative in predicting functional outcome, with a global accuracy of 75%. On a segmental basis, using an optimal threshold of uptake defined by receiver operating characteristic curve analysis, sestamibi was only 63% accurate in predicting regional outcome. Adding BMIPP improved the accuracy to 80% (P = 0.001). At follow-up, significant mismatching was still noted in 7 patients in the revascularized group and 1 in the medically treated group. The mismatch was associated with a further increase in ejection fraction at 1-y follow-up in only the revascularized group. CONCLUSION: In patients with chronic left ventricular dysfunction after infarction, a mismatching with BMIPP less than sestamibi reliably identifies jeopardized but viable myocardium and predicts functional recovery with an accuracy similar to that reported in the acute and subacute phases of the infarction. |
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Authors:
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A S Hambye; A A Dobbeleir; A M Vervaet; P A Van den Heuvel; P R Franken |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of nuclear medicine : official publication, Society of Nuclear Medicine Volume: 40 ISSN: 0161-5505 ISO Abbreviation: J. Nucl. Med. Publication Date: 1999 Sep |
Date Detail:
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Created Date: 1999-10-12 Completed Date: 1999-10-12 Revised Date: 2006-05-06 |
Medline Journal Info:
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Nlm Unique ID: 0217410 Medline TA: J Nucl Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1468-76 Citation Subset: IM |
Affiliation:
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Nuclear Medicine and Cardiology, Middelheim Hospital, Antwerp, Belgium. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Chronic Disease Echocardiography Fatty Acids / diagnostic use* Female Follow-Up Studies Gated Blood-Pool Imaging Humans Iodine Radioisotopes / diagnostic use* Iodobenzenes / diagnostic use* Male Middle Aged Myocardial Contraction Myocardial Infarction / complications*, therapy Myocardial Revascularization Predictive Value of Tests ROC Curve Radionuclide Angiography Radiopharmaceuticals / diagnostic use* Recovery of Function Sensitivity and Specificity Stroke Volume Technetium Tc 99m Sestamibi / diagnostic use* Tomography, Emission-Computed, Single-Photon Ventricular Dysfunction, Left / etiology, physiopathology, radionuclide imaging* |
| Chemical | |
Reg. No./Substance:
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0/Fatty Acids; 0/Iodine Radioisotopes; 0/Iodobenzenes; 0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi; 116754-87-1/iodofiltic acid |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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