Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Evaluation of myocardial viability bynuclear diagnostic methods: comparison of perfusionmyocardium scintigraphy with c 99mTc-technitril andpositron emission tomography with 18F-FDG inischemic heart disease patients

Authors: Bockeria L. A., Shurupova I. V., Aslanidi I. P., Trifonova T. A., Mukhortova O. V., Derevyanko E. P., Ekaeva I. V.

Link: Clinical Physiology of Blood Circulaiton. 2010; (): -

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Abstract

The aim of this investigation is the result comparison of perfusion scintigraphy with 99mTc-technetril (99mTc-tn) and positron-emission tomography with 18F- fluorodeoxyglucose (PET with 18F-FDG) in evaluation of myocardial viability of patients with IHD and comparison of prognostic value of methods. The analysis included the results of 111 patients examination in terms of regional or diffuse reduction of systolic myocardial thickening according to myocardial ECG-synchronized one-photon emission computed tomography (synchro-OFECT). According to the results we noted that metabolic rates of PET with 18F-FDG were the most approximate criteria of myocardial viability in comparison with perfusion data. PET-diagnostics sensitivity in this study exceeded 90%, overall accuracy of diagnostics was more than 85%. Perfusion scintigraphy allows to find primary information about myocardial viability. 99mTc-tn absorption within 31% - 50% of peak level is borderline and serves as the indication for myocardial-PET in estimation of metabolic preservation.

References

1. Бокерия, Л. А. Сравнительный анализ неинвазивных методов в диагностике аневризмы левого желудочка у больных ишемической болезнью сердца / Л. А. Бокерия, Е. З. Голухова, И. П. Асланиди и др. // Грудная и серд.-сосуд. хир. - 2003. - Т. 2. - С. 33-39.
2. Бокерия, Л. А. Сцинтиграфические показатели перфузии и функции миокарда ЛЖ у больных ИБС до и после реваскуляризации / Л. А. Бокерия, М. Н. Вахромеева, И. П. Асланиди и др. // Грудная и серд.-сосуд. хир. - 2003. - Т. 1. - С. 36-43.
3. Клюева, А. Ф. Оценка перфузии и метаболизма миокарда у больных ИБС до и после руваскуляризации методами позитронно-эмиссионной томографии и ЭКГ-синхронизированной однофотонной эмиссионной компьютерной томографии: автореф. дис. ... канд. мед. наук / А. Ф. Клюева. - М., 2004.
4. Altehoefer, C. Significance of defect severity in technetium- 99m-MIBI SPECT at rest to assess myocardial viability: comparison with fluorine-18-FDG PET / C. Altehoefer, J. vom Dahl, M. Biedemann et al. // J. Nucl. Med. - 1994. - Vol. 35. - P. 569-574.
5. Barrington, S. F. Comparison of sestamibi, thallium, echocardiography and PET for the detection of hibernating myocardium / S. F. Barrington, J. Chambers, W. A. Hallett et al. // Eur. J. Nucl. Med. Mol. Imaging. - 2004. - Vol. 31. - P. 355-361.
6. Bax, J. J. Sensivity, specificity and predictive accuracies of various noninvasive techniques for detecting hibernating myocardiaum / J. J. Bax, D. Poldermans, A. Elhendy et al. // Curr. Pobl. Cardiol. - 2001. - Vol. 26. - P. 141-186.
7. Beanland, R. S. Are the kinetics of technetium-99m-methoxyisobutyl isonitrile affected by cell metabolism and viability? / R. S. Beanlands, F. Dawood, W. H. Wen et al. // Circulation. - 1990. - Vol. 82. - P. 1802-1814.
8. Beanland, R. S. Positron emission tomography and recovery following revascularization (PARR-1): the importance of scar and the development of a prediction rule for the degree of recovery of left ventricular function / R. S. Beanland, T. D. Ruddy, R. A. deKemp et al. // J. Am. Coll. Cardiol. - 2002. - Vol. 40. - P. 1735-1743.
9. Bolli, R. Myocardial stunning in man / R. Bolli // Circulation - 1992. - Vol. 86. - P. 1671-1691.
10. Cabny, R. C. Relations of the myocardial imaging agents 99mTc-MIBI and 201Tl to myocardial blood flow in a canin model of myocardial ischemic insult / R. C. Cabny, S. Silber, G. M. Pohost // Circulation. - 1990. - Vol. 81 - P. 289-296.
11. Caldwell, J. H. Uptake kinetics of technetium-99m- methoxyisobuty- isonitrile and thallium-201 in adult rat heart endothelial and fibroblast-like cells in comparison to myocytes / J. H. Caldwell, H. Mertens, M. C. Linssen et al. // J. Nucl. Med. - 1992. - Vol. 33. - P. 102-107.
12. Crane, P. Effect of mitochondrial viability and metabolism on technetium-99m-sestamibi myocardial retention / P. Crane // Eur. J. Nucl. Med. - 1993. - Vol. 20. - P. 20-25.
13. Di Carli, M. F. Assessment of myocardial viability after myocardial infarction / M. F. Di Carli, R. Lalibert, S. Heminway et al. // J. Nucl. Cardiol. - 2002. - Vol. 9. - P. 229-235.
14. Freeman, I. Effect of coronary occlusion and myocardial viability on myocardial activity of technetium-99m-sestamibi / I. Freeman, A. M. Grunwald, S. Hoory et al. // J. Nucl. Med. - 1991. - Vol. 32. - P. 292-298.
15. Germano, G. Automatic quantification of regional myocardial wall motion and thickening from gated technetium-99m sestamibi myocardial perfusion single-photon emission computed tomography / G. Germano, J. Erel, H. Lewin et al. // J. Am. Coll. Cardiol. - 1997. - Vol. 30. - P. 1360-1367.
16. Mousa, S. A. Relationship between regional myocardial blood flow and the distribution of 99mTc-sestamibi in the presence of total coronary artery occlusion / S. A. Mousa, J. M. Cooney, S. J. Williams et al. // Am. Heart J. - 1990. - Vol. 119. - P. 842-847.
17. Piwnica-Worms, D. Enhancement by tetraphenylborate of technetium-99m-MIBI uptake kinetics and accumulation in cultured chick myocardial cells / D. Piwnica-Worms, J. F. Kronauge, M. L. Chiu J. // Nucl. Med. - 1991. - Vol. 32. - P. 1992-1999.
18. Piwnica-Worms, D. Uptake and retention of hexakis (2-methoxyisobuty isonitrile) technetium (I) in cultured check myocardial cells / D. Piwnica-Worms, J. F. Kronauge, M. L. Chiu // Circulation. - 1990. - Vol. 82. - P. 1826-1838.
19. Rahimtoola, S. H. The hibernating myocardium / S. H. Rahimtoola // Am. Heart J. - 1989. - Vol. 117. - P. 211-221.
20. Rahimtoola, Sh. H. Chronic ischemic left ventricular dysfunction: from pathophysiology to imaging and its integration into clinical practice / Sh. H. Rahimtoola, V. Dilsizian, Ch. M. Kramer et al. // J. Am. Col. Cardiol. Cardiovac. Imaging. - 2008. - Vol. 7 - P. 536-555.
21. Schelbert, H. R. Measurements of myocardial metabolism in patients with ischemic heart disease / H. R. Schelbert // Am. J. Cardiol. - 1998. - Vol. 82. - P. 61K-67K.
22. Schinkel, A. F. L. Assessment of myocardial viability in patients with heart falure / A. F. L. Schinkel, D. Polderman, A. Elhendy et al. // J. Nucl. Med. - 2007. - Vol. 48. - P. 1135-1146.
23. Sinusas, A. J. Effect of ischemia and postischemic dysfunction on myocardial uptake of technetium-99m-labled methoxyisobutyl isonitrile and thallium-201 / A. J. Sinusas, D. D. Watson, J. M. Cannon et al. // J. Am. Coll. Cardiol. - 1989. - Vol. 14. - P. 1785-1793.
24. Sorrentino, A. R. Comparison of the prognostic value of SPECT after nitrate administration and metabolic imaging by PET in patients with ischemic left ventricular dysfunction / A. R. Sorrentino, W. Acampa, M. Petrettaet et al. // Eur. J. Nucl. Med. Mol. Imaging. - 2007. - Vol. 34. - P. 558-562.
25. Underwood, S. R. Imaging techniques for the assessment of myocardial hibernation. Report of study group of the European Society of Cardiology / S. R. Underwood, J. J. Bax, J. Vom Dahl et al. // Eur. Heart J. - 2004. - Vol. 25. - P. 815-836.

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