Prediction of functional outcome after myocardial infarction using BMIPP and sestamibi scintigraphy.
We determined the predictive value of combined beta-methyl iodophenyl pentadecanoic acid (BMIPP) and sestamibi scintigraphy for the functional outcome after myocardial infarction and compared the value of this approach with dobutamine echocardiography.


METHODS
Rest BMIPP, rest sestamibi and low-dose dobutamine echocardiographic studies were obtained in 18 patients 4 to 10 days after infarction (mean 6.7 +/- 2.0 days). Six months later, a rest echocardiographic study was performed to assess functional outcome.


RESULTS
Wall motion improved in 27/33 segments (82%) which showed mismatching but not in 19/21 segments (90%) with matched defects (p < 0.001). The accuracy of combined BMIPP and sestamibi SPECT in predicting segmental functional outcome was higher (85%) than that of sestamibi uptake alone (77%). Wall motion improved in 16/20 segments (80%) showing contractile reserve and not in 21/34 segments (63%) with the negative dobutamine test, giving an accuracy of 69% for dobutamine echocardiography. Combination of the two techniques resulted in higher positive (94%) and negative predictive values (94%).


CONCLUSIONS
Mismatching of BMIPP and sestamibi uptake is predictive for long-term functional recovery after acute myocardial infarction. In contrast, segments with matched defects contain only scar tissue. Combined BMIPP and sestamibi scintigraphy offers increased accuracy compared to dobutamine echocardiography.
Franken
P R
PR
Department of Nuclear Medicine, University Hospital, Free University of Brussels, Belgium.
Dendale
P
P
De Geeter
F
F
Demoor
D
D
Bossuyt
A
A
Block
P
P
D017023:Coronary Angiography; D004280:Dobutamine; D004452:Echocardiography / Q000379:methods; D005227:Fatty Acids; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D017256:Technetium Tc 99m Sestamibi; D013997:Time Factors; D016277:Ventricular Function, Left / Q000502:physiology
D005227:Fatty Acids; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; C049338:iodofiltic acid; D004280:Dobutamine; D017256:Technetium Tc 99m Sestamibi