Document Detail


Comparison of dobutamine echocardiography and 99mTc-sestamibi tomography for prediction of left ventricular ejection fraction outcome after acute myocardial infarction treated with successful primary coronary angioplasty.
MedLine Citation:
PMID:  11801696     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
For patients with acute myocardial infarction who undergo primary percutaneous transluminal coronary angioplasty (PTCA), it is important to promptly identify those in whom a significant delayed improvement of global left ventricular function is to be expected as a result of successful treatment. METHODS: In 51 patients with acute myocardial infarction who underwent primary PTCA with a good angiographic result, the late outcome of the left ventricular ejection fraction (LVEF) was established after a 6-mo follow-up. In the early phase after infarction (within approximately 1 wk of infarction), the contractile reserve of the infarct zone was evaluated using dobutamine echocardiography and compared with the assessment of infarct size, infarct severity, and mean tracer activity of the infarct zone obtained using resting 99mTc-sestamibi SPECT. Receiver-operating-curve (ROC) analysis was used to define the reliability of the various parameters for identifying the patients with a follow-up LVEF increase of > or = 5 LVEF units. RESULTS: Of the 48 patients without restenosis at follow-up, 34 showed significant LVEF improvement. The evaluation of the contractile reserve of the infarct zone achieved an ROC curve area of 0.75 +/- 0.07 with 74% sensitivity, 71% specificity, and 73% overall accuracy. Of the 99mTc-sestamibi SPECT parameters, the extent of the infarct had no diagnostic value according to ROC analysis. The mean activity of the infarct zone had an ROC curve area of 0.64 +/- 0.09 with 82% sensitivity, 50% specificity, and 73% overall accuracy. The infarct severity had an ROC area of 0.76 +/- 0.08 (not significant vs. mean activity and vs. contractile reserve) with 77% sensitivity, 71% specificity, and 75% overall accuracy. CONCLUSION: Evaluation of the contractile reserve of the infarct zone using dobutamine echocardiography and assessment of the tracer activity of the infarct zone or infarct severity using 99mTc-sestamibi SPECT in the early phase after infarction are able to identify the patients in whom successful primary PTCA will be followed by significant late LVEF improvement.
Authors:
Roberto Sciagrà; Stelvio Sestini; Leonardo Bolognese; Giampaolo Cerisano; Piergiovanni Buonamici; Alberto Pupi
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of nuclear medicine : official publication, Society of Nuclear Medicine     Volume:  43     ISSN:  0161-5505     ISO Abbreviation:  J. Nucl. Med.     Publication Date:  2002 Jan 
Date Detail:
Created Date:  2002-01-21     Completed Date:  2002-02-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0217410     Medline TA:  J Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  8-14     Citation Subset:  IM    
Affiliation:
Nuclear Medicine Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy. r.sciagra@dfc.unifi-it
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary*
Dobutamine / diagnostic use*
Echocardiography*
Female
Humans
Male
Middle Aged
Myocardial Infarction / radionuclide imaging,  therapy*,  ultrasonography
ROC Curve
Radiopharmaceuticals / diagnostic use
Sensitivity and Specificity
Stroke Volume / physiology*
Technetium Tc 99m Sestamibi / diagnostic use*
Tomography, Emission-Computed, Single-Photon*
Ventricular Function, Left / physiology*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi; 34368-04-2/Dobutamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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