Document Detail


Low-dose dobutamine stress 99mTc tetrofosmin quantitative gated SPECT performed during the acute phase of myocardial infarction predicts subsequent myocardial viability and detects stunned myocardium.
MedLine Citation:
PMID:  12548041     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study evaluated the ability of low-dose dobutamine stress 99mTc tetrofosmin (DSTF) quantitative gated single photon emission computed tomography (QGS) performed during the acute phase of myocardial infarction to predict subsequent myocardial viability and detect stunned myocardium. Twenty-four patients suffering their first acute myocardial infarction (AMI) underwent coronary angioplasty after coronary angiography (CAG) immediately following admission. Follow-up CAG and left ventriculography (LVG) were performed 10 days and 6 months later. All patients underwent DSTF QGS to measure left ventricular ejection fraction (LVEF) at rest and during dobutamine infusion (10 microg.kg(-1).min(-1)) 14 days after angioplasty. No patient suffered coronary restenosis. After 6 months, the LVEF measured by LVG improved >5% in 12 patients (group A), and did not improve in the remaining 12 patients (group B). The culprit coronary artery, the peak serum creatine phosphokinase concentration, the recanalization time, and the LVEF during the acute phase were similar in the two groups. However, the increase in the LVEF was greater in group A than in group B during dobutamine infusion (deltaLVEF) as measured by DSTF QGS (11.2+/-3.8% vs 2.9+/-4.7%, P <0.001). If a cut-off value of 6.5% for the deltaLVEF was used to predict the improvement in LVEF during the chronic phase, then the sensitivity of this test was 83.3% and its specificity was 83.3%. It is concluded that DSTF QGS during AMI can be used to predict myocardial viability and detect stunned myocardium.
Authors:
S Kasama; T Toyama; H Kumakura; Y Takayama; S Ichikawa; T Suzuki; M Kurabayashi
Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Nuclear medicine communications     Volume:  24     ISSN:  0143-3636     ISO Abbreviation:  Nucl Med Commun     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-01-27     Completed Date:  2003-09-05     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8201017     Medline TA:  Nucl Med Commun     Country:  England    
Other Details:
Languages:  eng     Pagination:  167-74     Citation Subset:  IM    
Affiliation:
Second Department of Internal Medicine, Gunma University School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma 371-0034, Japan. s-kasama@bay.wind.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Aged, 80 and over
Dobutamine / diagnostic use*
Female
Follow-Up Studies
Gated Blood-Pool Imaging / methods*
Heart Ventricles / radionuclide imaging
Humans
Male
Middle Aged
Myocardial Infarction / complications,  diagnosis,  radionuclide imaging*,  surgery
Myocardial Stunning / diagnosis,  etiology,  radionuclide imaging*
Organophosphorus Compounds / diagnostic use*
Organotechnetium Compounds / diagnostic use*
Radiopharmaceuticals / diagnostic use
Reproducibility of Results
Sensitivity and Specificity
Stress, Physiological / chemically induced
Stroke Volume
Tissue Survival
Ventricular Dysfunction, Left / etiology,  radionuclide imaging*
Chemical
Reg. No./Substance:
0/Organophosphorus Compounds; 0/Organotechnetium Compounds; 0/Radiopharmaceuticals; 0/technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane; 34368-04-2/Dobutamine

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