| Relationship between infarct size and severity measured by gated SPECT and long-term left ventricular remodelling after acute myocardial infarction. | |
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MedLine Citation:
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PMID: 21327635 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: After acute myocardial infarction (AMI), left ventricular (LV) remodelling may occur despite successful reperfusion. This study aimed to investigate by gated single photon emission computed tomography (SPECT) the long-term evolution of myocardial perfusion and LV function after AMI and to identify the predictors of LV remodelling. METHODS: Sixty-eight AMI patients successfully treated by primary percutaneous coronary intervention underwent (99m)Tc-sestamibi gated SPECT at 1 month (baseline) and over 6-month follow-up after the acute event. LV remodelling was defined as 20% increase in LV end-diastolic volume at follow-up. RESULTS: At baseline, patients with remodelling (n = 14) showed larger (infarct size 29.3 ± 7.8%) and more transmural (infarct severity 0.28 ± 0.10) infarctions, and reduced LV ejection fraction (35.4 ± 5.6%), but similar LV volume indexes, compared to patients without remodelling (n = 54) (infarct size 20.8 ± 14.4%, p < 0.05, infarct severity 0.40 ± 0.11, p < 0.001, ejection fraction 44.5 ± 9.2, p < 0.001). At stepwise multivariate regression analysis, infarct severity showed the best predictive value for predicting LV remodelling (F = 5.54, p < 0.05). Using the thresholds identified by receiver-operating characteristic curve analysis, infarct size and severity detected patients with remodelling with 75% accuracy and 95% negative predictive value. Infarct resorption (defined as the defect size difference between follow-up and baseline) was comparable between patients with (-4.4 ± 8.4%) and without remodelling (-6.8 ± 9.4%) (p = NS). CONCLUSION: Perfusion parameters assessed by gated SPECT in the subacute phase after successfully treated AMI correlate with changes in functional parameters at long-term follow-up. Infarct severity is more effective than infarct size, but both are helpful for predicting LV remodelling. |
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Authors:
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Valentina Berti; Roberto Sciagrà; Wanda Acampa; Francesca Ricci; Giampaolo Cerisano; Rosj Gallicchio; Carlo Vigorito; Alberto Pupi; Alberto Cuocolo |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-2-15 |
Journal Detail:
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Title: European journal of nuclear medicine and molecular imaging Volume: - ISSN: 1619-7089 ISO Abbreviation: - Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-2-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101140988 Medline TA: Eur J Nucl Med Mol Imaging Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Nuclear Medicine Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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