title: Sublingual nitrate plus 99Tcm-tetrofosmin infusion in the detection of severely ischaemic but viable myocardium: a comparative study with stress, redistribution, reinjection and late redistribution 201Tl imaging.
abstract: To investigate the role of sublingual nitrate plus 99Tcm-tetrofosmin infusion in the detection of severely ischaemic but viable myocardium, we selected 25 patients with coronary artery disease who had at least one fixed segmental defect during conventional stress-redistribution (ST-RD) 201Tl single photon emission tomographic (SPET) imaging. Reinjection (RI) and 24 h late redistribution (LRD) imaging were also performed. Within a week of 201Tl imaging, one-day rest-stress (R-ST) 99Tcm-tetrofosmin SPET was performed with the same stress levels. The following day, 99Tcm-tetrofosmin was infused over 1 h immediately after sublingual nitrate administration and SPET images (N + Inf) were acquired. Of 100 fixed defects on R-ST 99Tcm-tetrofosmin imaging, 15 were reversible on N + Inf 99Tcm-tetrofosmin imaging. There was 91% concordance between ST-RD/RI/LRD 201Tl and R-ST/N + Inf 99Tcm-tetrofosmin imaging regarding reversibility. We conclude that N + Inf 99Tcm-tetrofosmin imaging may be clinically useful in the detection of severely ischaemic but viable myocardium.
authors.affiliation: Department of Nuclear Medicine, School of Medicine, Dokuz Eylul University, Inciralti, Izmir, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Derebek
authors.forename: O
authors.initials: O
authors.lastname: Kozan
authors.forename: H
authors.initials: H
authors.lastname: Durak
authors.forename: O
authors.initials: O
authors.lastname: Ergene
authors.forename: E
authors.initials: E
authors.lastname: Ozbilek
authors.forename: G
authors.initials: G
authors.lastname: Capa
authors.forename: A
authors.initials: A
authors.lastname: Belgi
authors.forename: Y
authors.initials: Y
authors.lastname: Yurekli
authors.forename: B
authors.initials: B
authors.lastname: Degirmenci
authors.forename: S
authors.initials: S
authors.lastname: Dogan
mesh_terms: D000286:Administration, Sublingual; D000328:Adult; D000368:Aged; D002544:Cerebral Infarction; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D009566:Nitrates / Q000008:administration & dosage; D009943:Organophosphorus Compounds / Q000008:administration & dosage / Q000493:pharmacokinetics; D015609:Organotechnetium Compounds / Q000008:administration & dosage / Q000493:pharmacokinetics; D005082:Physical Exertion; D019275:Radiopharmaceuticals / Q000008:administration & dosage; D013794:Thallium Radioisotopes / Q000493:pharmacokinetics; D014018:Tissue Distribution; D014055:Tomography, Emission-Computed
chemical_list: D009566:Nitrates; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes; C078700:technetium tc-99m tetrofosmin