title: Value of rest thallium-201/technetium-99m sestamibi scans and dobutamine echocardiography for detecting myocardial viability.
abstract: The relation between radioisotopic and echocardiographic markers of myocardial viability and postrevascularization recovery of function is still to be defined. To this purpose, 14 patients (11 men, 3 women, aged 35 to 64 years, mean 54 +/- 7) with ventricular dysfunction were studied by a multiparametric approach. Each patient underwent, on separate days, rest thallium-201 and technetium-99m sestamibi scintigraphy, dobutamine echocardiography and coronary angiography. Coronary angiography was analyzed by a quantitative approach. Thallium uptake at rest was quantified from planar early (10-minute) and delayed (16-hour) thallium-201 images and expressed as a percentage of maximal activity in each projection using a 13-segment model. Sestamibi uptake was expressed in the same way. Dobutamine (up to 10 micrograms/kg/min) echocardiography was analyzed using a score index ranging from 1 (normokinesia) to 4 (dyskinesia) and a similar segmental model. Before revascularization 50 segments were grouped as normal (coronary stenosis < 50% and normal function, group 1); of the remaining 132 segments with > 50% coronary stenosis, 57 had normal wall motion (group 2) and 75 showed regional dyssynergies (group 3). Early and delayed thallium-201 regional percent activities did not differ in group 1 and in group 2 but were significantly less in group 3 segments. Sestamibi percent activity was more in group 1 and significantly reduced both in group 2 and 3 segments. Segments with improved wall motion after dobutamine had more early, delayed thallium-201 and sestamibi percent activities than unresponsive segments. Postrevascularization echocardiography was performed in all patients. Delayed thallium-201 scans and dobutamine echocardiography showed good sensitivity and specificity in detecting viable myocardium. (ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: CNR Institute of Clinical Physiology, Pisa, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Marzullo
authors.forename: O
authors.initials: O
authors.lastname: Parodi
authors.forename: B
authors.initials: B
authors.lastname: Reisenhofer
authors.forename: G
authors.initials: G
authors.lastname: Sambuceti
authors.forename: E
authors.initials: E
authors.lastname: Picano
authors.forename: A
authors.initials: A
authors.lastname: Distante
authors.forename: A
authors.initials: A
authors.lastname: Gimelli
authors.forename: A
authors.initials: A
authors.lastname: L'Abbate
mesh_terms: D017023:Coronary Angiography; D004280:Dobutamine; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D013794:Thallium Radioisotopes
chemical_list: D013794:Thallium Radioisotopes; D004280:Dobutamine; D017256:Technetium Tc 99m Sestamibi