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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)

Javadi, H. and Porpiranfar, M.A. and Semnani, S. and Jallalat, S. and Yavari, P. and Mogharrabi, M. and Hooman, A. and Amini, A. and Barekat, M. and Iranpour, D. and Seyedabadi, M. and Assadi, M. and Asli, I.N. (2011) 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). Perfusion, 26 (5). pp. 409-421. ISSN 02676591 (ISSN)

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Abstract

Introduction: This study was performed to determine the clinical application of rest 99mTc-sestamibi in the assessment of viability and functional improvement of the left ventricle (LV) myocardium in the post-thrombolytic therapy of acute myocardial 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 and 3-5 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 change in LV ejection fraction (EF) were evaluated using stepwise multiple regression analysis. Results: Thirty-seven patients (30 men and 7 women; mean age: 58±14 years) with AMI were enrolled in the study. Redistribution was observed in 35 and 50 segments of the initial and follow-up scans, respectively. In addition, 146 segments with reverse redistribution (RR), both in the initial scan (118 segments) and the follow-up scan (86 segments), were also observed. An apparent difference in wall motion scores was seen between the initial and follow-up echocardiographs (p<0.001). Furthermore, using the optimal cut-off point of perfusion percentage in each image set, sensitivity as well as specificity and likelihood ratio (LR) for the improvement of regional wall motion after 3-5 months were defined. Conclusion: These data showed that redistribution and reverse redistribution of 99mTc-sestamibi post thrombolytic therapy can be used as a marker of viability to predict the 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 LV function status and can predict the recovery of jeopardized myocardium function after thrombolytic therapy. © 2011 SAGE Publications.

Item Type: Article
Additional Information: Unmapped bibliographic data: LA - English [Field not mapped to EPrints] J2 - Perfusion [Field not mapped to EPrints] AD - Golestan Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences (GUOMS), Gorgan, Iran [Field not mapped to EPrints] AD - Department of Cardiology, Taleghani Hospital, Shaheed Beheshti University of Medical Science, Tehran, Iran [Field not mapped to EPrints] AD - Department of Nuclear Medicine, Taleghani Hospital, Shaheed Beheshti University of Medical Science, Tehran, Iran [Field not mapped to EPrints] AD - Persian Gulf Nuclear Medicine Research Center, Persian Gulf Biomedical Sciences Institute, Boostan 19 Alley, Sangi Street, Bushehr, Iran [Field not mapped to EPrints] DB - Scopus [Field not mapped to EPrints]
Uncontrolled Keywords: 99mTc-sestamibi, acute myocardial infarction, redistribution, streptokinase, enoxaparin, heparin, methoxy isobutyl isonitrile technetium tc 99m, streptokinase, adult, aged, article, blood clot lysis, clinical article, convalescence, drug distribution, drug uptake, female, heart function, heart left ventricle ejection fraction, heart muscle perfusion, human, image analysis, image processing, image reconstruction, male, parameter, prediction, priority journal, scintillation camera, sensitivity and specificity, single photon emission computer tomography, ST segment elevation myocardial infarction, treatment outcome, treatment response
Subjects: مقالات نمایه شده محققین دانشگاه در سایت ,Web of Science ,Scopus
موارد کلی
Divisions: معاونت تحقیقات و فناوری
Depositing User: GOUMS
Date Deposited: 20 Apr 2015 04:08
Last Modified: 16 May 2015 06:13
URI: http://eprints.goums.ac.ir/id/eprint/2099

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