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Serial dual single-photon emission computed tomography of thallium-201 and iodine-123 beta-methyliodophenyl pentadecanoic acid scintigraphy can predict functional recovery of patients with coronary artery disease after coronary artery bypass graft surgery.
MedLine Citation:
PMID:  25321160     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: A mismatch between thallium-201 (Tl) and iodine-123 (I)-beta-methyl iodophenyl pentadecanoic acid (BMIPP) dual single-photon emission computed tomography (SPECT) reflects a dysfunctional but viable myocardium, such as stunned or hibernating myocardium, in patients with coronary artery disease (CAD). However, the cardiac function does not always improve after revascularization. The present study aimed to determine whether serial Tl and I-BMIPP dual SPECT can predict improvements in cardiac function after coronary artery bypass graft surgery (CABG) in patients with CAD.
MATERIALS AND METHODS: The study included 98 patients with CAD requiring CABG and having a left ventricular ejection fraction (LVEF) less than 50%. The total defect score (TDS) was calculated from Tl and I-BMIPP dual-SPECT images acquired before and 3 weeks after CABG. The LVEF, left ventricular end-diastolic volume index, and end-systolic volume index were determined by means of contrast left ventriculography before and 6 months after CABG.
RESULTS: After 6 months, LVEF improved by 5% or more in 62 patients (group A) but did not improve in the remaining 36 patients (group B). Baseline Tl-TDS was significantly lower (9.1±4.6 vs. 14.6±6.5, P<0.001), and the mismatch score (BMIPP-TDS-Tl-TDS) was significantly higher (6.9±4.2 vs. 4.2±3.9, P=0.002) in group A than in group B. The extent of change in BMIPP-TDS 3 weeks after CABG compared with that before (delta-BMIPP-TDS) was significantly greater in group A than in group B (-5.9±3.0 vs. 2.8±4.3, P<0.001). Stepwise multivariate analysis selected delta-BMIPP-TDS as a significant independent predictor of improvement in LVEF at 6 months after CABG (multivariate β-coefficient=-0.718, P<0.001). The degree of change in LVEF 6 months after CABG compared with that before significantly and negatively correlated with delta-BMIPP-TDS (r=-0.631, P<0.001).
CONCLUSION: The delta-BMIPP-TDS evaluated by serial Tl and I-BMIPP dual SPECT can predict improvements in cardiac function during the chronic phase of CAD.
Authors:
Kishu Fujita; Shu Kasama; Masahiko Kurabayashi
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-15
Journal Detail:
Title:  Nuclear medicine communications     Volume:  -     ISSN:  1473-5628     ISO Abbreviation:  Nucl Med Commun     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-10-16     Completed Date:  -     Revised Date:  2014-10-17    
Medline Journal Info:
Nlm Unique ID:  8201017     Medline TA:  Nucl Med Commun     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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