Document Detail


Preoperative identification of viable myocardium: effectiveness of nitroglycerine-induced changes in myocardial Sestamibi uptake.
MedLine Citation:
PMID:  9610828     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In order to predict tissue viability in infarcted myocardial areas, changes induced by nitroglycerine infusion on Sestamibi myocardial uptake were evaluated in 37 patients with previously confirmed myocardial infarction undergoing coronary artery bypass grafting, and compared with echocardiographic and perfusional changes occurring after the operation. The improvement of Sestamibi uptake after nitroglycerine correctly classified 24/26 (92%) patients showing postoperative improvement of wall motion in the infarcted area, whereas 24/31 (77%) patients with nitroglycerine-induced increase in Sestamibi uptake had improved wall motion after operation. The presence of collateral flow to the infarcted area was associated with a significantly (P < 0.01) higher increase in Sestamibi uptake both during nitroglycerine infusion and postoperatively. An increase in wall motion score after operation was associated with a significantly higher (P < 0.05) increase in Sestamibi uptake score during nitroglycerine infusion. Thus, the results of this study suggest that Sestamibi perfusional myocardial scintigraphy during nitroglycerine infusion is capable of assessing viable but chronically hypoperfused myocardium and predicting postoperative wall motion and perfusional improvement, to yield the best results in patients with evidence of collateral circulation that supplies the infarcted area.
Authors:
C Greco; M Ciavolella; G Tanzilli; R Sinatra; F Macrina; O Schillaci; R Tavolaro; F Scopinaro; P P Campa; B Marino
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Cardiovascular surgery (London, England)     Volume:  6     ISSN:  0967-2109     ISO Abbreviation:  Cardiovasc Surg     Publication Date:  1998 Apr 
Date Detail:
Created Date:  1998-07-30     Completed Date:  1998-07-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9308765     Medline TA:  Cardiovasc Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  149-55     Citation Subset:  IM    
Affiliation:
Institute of Cardiac Surgery, Department of Experimental Medicine, University La Sapienza, Rome, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Artery Bypass
Coronary Circulation / drug effects
Echocardiography
Heart / drug effects*,  radionuclide imaging*
Heart Catheterization
Humans
Infusions, Intravenous
Male
Middle Aged
Myocardial Infarction / diagnosis,  drug therapy*,  radionuclide imaging*,  surgery
Nitroglycerin / administration & dosage*
Predictive Value of Tests
Preoperative Care
Radiopharmaceuticals / diagnostic use*
Sensitivity and Specificity
Technetium Tc 99m Sestamibi / diagnostic use*
Vasodilator Agents / administration & dosage*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 0/Vasodilator Agents; 109581-73-9/Technetium Tc 99m Sestamibi; 55-63-0/Nitroglycerin

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


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