Influence of the assessment of defect severity and intravenous nitrate administration during tracer injection on the detection of viable hibernating myocardium with data-based quantitative technetium 99m-labeled sestamibi single-photon emission computed tomography.
BACKGROUND
This study aimed to verify whether the assessment of defect severity and the infusion of nitrates during tracer injection improve the capability of data-based 99mTc-labeled sestamibi single-photon emission computed tomography (SPECT) to recognize hibernating myocardium.


RESULTS
Of 66 asynergic coronary territories in 40 patients with left ventricular dysfunction, 28 had postrevascularization functional recovery (hibernating) and 38 had unchanged dysfunction (fibrotic). Defect severity was lower in the hibernating than in the fibrotic territories on both baseline (p < 0.01) and nitrate SPECT (p < 0.002). Nitrate was superior to baseline SPECT to differentiate the hibernating from the fibrotic territories (sensitivity 96% vs 75%, p < 0.05; receiver-operating characteristic curve area 0.75 vs 0.63, p < 0.001) and to identify the patients with improved left ventricular ejection fraction (receiver-operating characteristic curve area 0.68 vs 0.58; p < 0.05).


CONCLUSIONS
The analysis of defect severity in combination with nitrate infusion clearly improves the value of 99mTc-labeled sestamibi SPECT for the recognition of hibernating myocardium and the prediction of postrevascularization recovery.
Sciagrà
R
R
Department of Clinical Pathophysiology, University of Florence, Italy.
Bisi
G
G
Santoro
G M
GM
Agnolucci
M
M
Zoccarato
O
O
Fazzini
P F
PF
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007548:Isosorbide Dinitrate; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D017682:Myocardial Stunning / Q000000981:diagnostic imaging* / Q000601:surgery; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon; D014665:Vasodilator Agents; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000601:surgery; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology
D014665:Vasodilator Agents; D017256:Technetium Tc 99m Sestamibi; D007548:Isosorbide Dinitrate