Document Detail


Prognostic values of perfusion-metabolic mismatch in Tl-201 and BMIPP scintigraphic imaging in patients with chronic coronary artery disease and left ventricular dysfunction undergoing revascularization.
MedLine Citation:
PMID:  12043904     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to assess the prognostic value of the amount of perfusion-metabolic mismatch in revascularized patients with left ventricular (LV) dysfunction by means of Thallium (Tl)-201 and BMIPP imaging. METHODS: Seventy-six patients with LV dysfunction and coronary artery disease underwent Tl-201 and BMIPP imaging. They were revascularized with either coronary artery bypass graft or balloon angioplasty and were entered into this study. To quantify the amount of perfusion-metabolic mismatch, SPECT images were displayed as polar maps and analyzed semiquantitatively. The patients were followed up for a mean period of 32 months for cardiac mortality and non-fatal cardiac events. Standard follow-up left ventriculography was performed 6 to 12 months after revascularization. RESULTS: Thirty-two patients exhibited a large amount of perfusion-metabolic mismatch (> 7 segments, group A), 28 patients had a small amount of perfusion-metabolic mismatch (2 to 6 segments, group B), and 16 patients were found to have no perfusion-metabolic mismatch (group C). Similar pre-revascularization LVEF of 35 +/- 5%, 34 +/- 8% and 36 +/- 6% increased to 45 +/- 8% (p < 0.0001), to 38 +/- 8% (p < 0.05), and to 36 +/- 3% (n.s.), respectively, after revascularization. The functional improvement after revascularization in group A was accompanied by a low rate of cardiac events during follow-up and better cardiac event free survival as judged by the Kaplan-Meier method (p < 0.05, vs. group B and C). CONCLUSION: In revascularized patients with severe LV dysfunction, the presence of a large amount of perfusionmetabolic mismatch evaluated by Tl-201 and BMIPP imaging identifies patients with the best prognosis.
Authors:
Shigeru Fukuzawa; Shun Ozawa; Kazuhiro Shimada; Juji Sugioka; Masayuki Inagaki
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of nuclear medicine     Volume:  16     ISSN:  0914-7187     ISO Abbreviation:  Ann Nucl Med     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-06-04     Completed Date:  2002-12-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8913398     Medline TA:  Ann Nucl Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  109-15     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Funabashi Municipal Medical Center, Chiba, Japan. sf-fuku@qa2.so-net.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Artery Bypass
Coronary Artery Disease / metabolism,  radionuclide imaging*,  surgery
Fatty Acids / diagnostic use*
Female
Humans
Iodine Radioisotopes / diagnostic use*
Iodobenzenes / diagnostic use*
Male
Middle Aged
Myocardial Revascularization
Prognosis
Radiopharmaceuticals / diagnostic use
Thallium Radioisotopes / diagnostic use*
Treatment Outcome
Ventricular Dysfunction, Left / metabolism,  radionuclide imaging*,  surgery
Chemical
Reg. No./Substance:
0/Fatty Acids; 0/Iodine Radioisotopes; 0/Iodobenzenes; 0/Radiopharmaceuticals; 0/Thallium Radioisotopes; 116754-87-1/iodofiltic acid

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