title: Comparison between exercise and trans-oesophageal atrial pacing in patients with coronary artery disease: technetium-99m methoxy isobutyl isonitrile simultaneous evaluation of ventricular function and myocardial perfusion.
abstract: In this study we compared the results of exercise and trans-oesophageal atrial pacing (TAP) technetium-99m methoxyisobutyl isonitrile (99mTc-SESTAMIBI) cardiac imaging in the evaluation of left ventricular (LV) function and myocardial perfusion in patients with angiographically proven coronary artery disease. Ten patients (8 men and 2 women, mean age 59 +/- 6 years) were submitted to 3 separate injections of 99mTc-SESTAMIBI, one under control conditions, one after exercise and one after TAP. LV ejection fraction, as measured by electrocardiogram (ECG) gated first pass, decreased from 49 +/- 5% under control conditions to 42 +/- 6% during exercise (P less than 0.05 versus control) and to 43 +/- 8% during TAP (P less than 0.05 versus control and insignificant change versus exercise). Segmental myocardial perfusion analysis was performed on a total of 150 myocardial segments. On both exercise and TAP 99mTc-SESTAMIBI studies, 103 segments (69% of the total) were normal, 32 (21%) had reversible, and 15 (10%) irreversible, perfusion defects. Relative regional tracer uptake was not statistically different between exercise and TAP in normal regions (91.1 +/- 9.1% versus 90.7 +/- 8.5%, respectively), in regions with reversible (61.9 +/- 12% versus 62.4 +/- 10.4%, respectively) and irreversible perfusion defects (55.8 +/- 7.8% versus 58.8 +/- 9.5%, respectively). Our results demonstrated that 99mTc-SESTAMIBI TAP cardiac imaging shows similar results to 99mTc-SESTAMIBI exercise myocardial scintigraphy in the assessment of LV function and myocardial perfusion in patients with coronary artery disease.
authors.affiliation: Department of Nuclear Medicine, Second Medical School, Università Federico II, Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Cuocolo
authors.forename: M
authors.initials: M
authors.lastname: Santomauro
authors.forename: L
authors.initials: L
authors.lastname: Pace
authors.forename: L
authors.initials: L
authors.lastname: Celentano
authors.forename: A
authors.initials: A
authors.lastname: Nappi
authors.forename: E
authors.initials: E
authors.lastname: Nicolai
authors.forename: M
authors.initials: M
authors.lastname: Chiariello
authors.forename: M
authors.initials: M
authors.lastname: Salvatore
mesh_terms: D002304:Cardiac Pacing, Artificial / Q000379:methods*; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009570:Nitriles; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D017256:Technetium Tc 99m Sestamibi; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D009570:Nitriles; D015609:Organotechnetium Compounds; D017256:Technetium Tc 99m Sestamibi