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Scintigraphic parameters with emphasis on perfusion appraisal in rest 99mTc-sestamibi SPECT in the recovery of myocardial function after thrombolytic therapy in patients with ST elevation myocardial infarction (STEMI).
MedLine Citation:
PMID:  21593086     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: This study was performed to determine the clinical application of rest 99mTc-sestamibi in the assessmentof viability and functional improvement of the left ventricle (LV) myocardium in the post-thrombolytic therapy of acutemyocardial infarction (AMI). Material and methods: In 37 patients with AMI who received thrombolytic therapy, 2-dimensional(2D) echocardiography, as well as the resting redistribution of 99mTc-sestamibi, was investigated, both within 1 week and3-5 months after AMI. The predictive capacity of the perfusion percentage for myocardial function recovery was evaluated.Also, the capacities of the possible variables in the prediction of recovery of myocardial function resulting from a changein LV ejection fraction (EF) were evaluated using stepwise multiple regression analysis. RESULTS: Thirty-seven patients (30men and 7 women; mean age: 58±14 years) with AMI were enrolled in the study. Redistribution was observed in 35 and 50segments of the initial and follow-up scans, respectively. In addition, 146 segments with reverse redistribution (RR), bothin the initial scan (118 segments) and the follow-up scan (86 segments), were also observed. An apparent difference in wallmotion scores was seen between the initial and follow-up echocardiographs (p<0.001). Furthermore, using the optimalcut-off point of perfusion percentage in each image set, sensitivity as well as specificity and likelihood ratio (LR) for theimprovement of regional wall motion after 3-5 months were defined. CONCLUSION: These data showed that redistributionand reverse redistribution of 99mTc-sestamibi post thrombolytic therapy can be used as a marker of viability to predictthe recovery of segmental wall motion abnormality (stunning), as well as the improvement of segmental perfusion uptake.This study also demonstrates that the resting 99mTc-sestamibi SPECT can be used for an approximate assessment of LVfunction status and can predict the recovery of jeopardized myocardium function after thrombolytic therapy.
Authors:
H Javadi; M A Porpiranfar; S Semnani; S Jallalat; P Yavari; M Mogharrabi; A Hooman; A Amini; M Barekat; D Iranpour; M Seyedabadi; M Assadi; I N Asli
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-18
Journal Detail:
Title:  Perfusion     Volume:  -     ISSN:  1477-111X     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8700166     Medline TA:  Perfusion     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Golestan Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences (GUOMS), Gorgan, Iran.
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