OBJECTIVES: This study aimed to define the optimal criteria for detecting viable myocardium with rest-redistribution thallium-201 (Tl-201) or baseline-nitrate technetium-99m (Tc-99m) sestamibi single-photon emission computed tomography (SPECT) using discriminant analysis and to compare the accuracy of the two tracers in predicting postrevascularization recovery. BACKGROUND: Rest-redistribution Tl-201 imaging is currently used for detection of myocardial viability, but the optimal variables for territory classification have not yet been defined. Although Tc-99m sestamibi is reportedly less effective than Tl-201, its reliability can be increased by injecting it during nitrate infusion. METHODS: In 35 patients with left ventricular (LV) dysfunction, tracer activity within asynergic coronary territories was quantified on rest and redistribution Tl-201 and baseline and nitrate Tc-99m sestamibi SPECT. Asynergic territory viability was evaluated on the basis of the postrevascularization functional outcome. RESULTS: Percent activity within asynergic territories was significantly influenced by their viability (p < 0.005) and the type of acquisition (p < 0.0001) but not by the tracer used. Discriminant analysis identified redistribution Tl-201 activity and nitrate-induced Tc-99m sestamibi activity change as the two most significant predictors of postrevascularization recovery. The discriminant function defined for Tl-201, including redistribution activity and reversibility, correctly classified 38 of 56 asynergic territories, whereas that for Tc-99m sestamibi, including nitrate-induced activity change and activity in nitrate images, correctly classified 43 territories. CONCLUSIONS: Redistribution activity is more important than reversibility when differentiating viable from nonviable territories using rest-redistribution Tl-201. In Tc-99m sestamibi SPECT, nitrate-induced activity changes are particularly useful in identifying myocardial viability. Baseline-nitrate Tc-99m sestamibi SPECT appears no less effective than rest-redistribution Tl-201 in predicting postrevascularization recovery.
OBJECTIVES: This study aimed to define the optimal criteria for detecting viable myocardium with rest-redistribution thallium-201 (Tl-201) or baseline-nitrate technetium-99m (Tc-99m) sestamibi single-photon emission computed tomography (SPECT) using discriminant analysis and to compare the accuracy of the two tracers in predicting postrevascularization recovery. BACKGROUND: Rest-redistribution Tl-201 imaging is currently used for detection of myocardial viability, but the optimal variables for territory classification have not yet been defined. Although Tc-99m sestamibi is reportedly less effective than Tl-201, its reliability can be increased by injecting it during nitrate infusion. METHODS: In 35 patients with left ventricular (LV) dysfunction, tracer activity within asynergic coronary territories was quantified on rest and redistribution Tl-201 and baseline and nitrate Tc-99m sestamibi SPECT. Asynergic territory viability was evaluated on the basis of the postrevascularization functional outcome. RESULTS: Percent activity within asynergic territories was significantly influenced by their viability (p < 0.005) and the type of acquisition (p < 0.0001) but not by the tracer used. Discriminant analysis identified redistribution Tl-201 activity and nitrate-induced Tc-99m sestamibi activity change as the two most significant predictors of postrevascularization recovery. The discriminant function defined for Tl-201, including redistribution activity and reversibility, correctly classified 38 of 56 asynergic territories, whereas that for Tc-99m sestamibi, including nitrate-induced activity change and activity in nitrate images, correctly classified 43 territories. CONCLUSIONS: Redistribution activity is more important than reversibility when differentiating viable from nonviable territories using rest-redistribution Tl-201. In Tc-99m sestamibi SPECT, nitrate-induced activity changes are particularly useful in identifying myocardial viability. Baseline-nitrate Tc-99m sestamibi SPECT appears no less effective than rest-redistribution Tl-201 in predicting postrevascularization recovery.
Authors: M Leoncini; G Marcucci; R Sciagrà; F Frascarelli; F Bellandi; M Gallopin; A Mennuti; R P Dabizzi Journal: J Nucl Cardiol Date: 2001 Sep-Oct Impact factor: 5.952
Authors: E Gordon Depuey; John J Mahmarian; Todd D Miller; Andrew J Einstein; Christopher L Hansen; Thomas A Holly; Edward J Miller; Donna M Polk; L Samuel Wann Journal: J Nucl Cardiol Date: 2012-04 Impact factor: 5.952
Authors: Thomas A Holly; Robert O Bonow; J Malcolm O Arnold; Jae K Oh; Padmini Varadarajan; Gerald M Pohost; Haissam Haddad; Robert H Jones; Eric J Velazquez; Bozena Birkenfeld; Federico M Asch; Marcin Malinowski; Rodrigo Barretto; Renato A K Kalil; Daniel S Berman; Jie-Lena Sun; Kerry L Lee; Julio A Panza Journal: J Thorac Cardiovasc Surg Date: 2014-07-30 Impact factor: 5.209
Authors: M Bountioukos; A F L Schinkel; J J Bax; V Rizzello; R Rambaldi; E C Vourvouri; J R T C Roelandt; D Poldermans Journal: Heart Date: 2003-11 Impact factor: 5.994
Authors: M Bountioukos; A F L Schinkel; J J Bax; V Rizzello; R Valkema; B J Krenning; E Biagini; E C Vourvouri; J R T C Roelandt; D Poldermans Journal: Heart Date: 2004-05 Impact factor: 5.994