Mismatch between myocardial accumulation of 123I-MIBG and 99mTc-MIBI and late ventricular potentials in patients after myocardial infarction: association with the development of ventricular arrhythmias.
BACKGROUND
Late ventricular potentials are widely used to predict life-threatening arrhythmias, although the predictive value is low. To improve prediction, we correlated the incidence of ventricular arrhythmias with mismatches in myocardial 99mTc-methoxyisobutylisonitrile (MIBI)/(123)I-metaiodobenzylguanidine (MIBG) accumulation and late ventricular potentials (LP).


RESULTS
Fifty patients with old myocardial infarctions were divided into an LP-positive group (n = 19) and an LP-negative group (n = 31). On bull's-eye single photon emission computed tomographic MIBI and MIBG images, the heart was divided into 9 segments to evaluate the accumulation of the 2 nuclides. There was no difference in total defect score (TDS) for MIBI between the LP-positive and LP-negative groups. However, TDS for MIBG and differences TDS between MIBI and MIBG (ATDS) were significantly greater in the LP-positive group.


CONCLUSIONS
The incidence of severe ventricular arrhythmias was greater among patients with an increased ATDS in the LP-positive group. Thus the combination of these two methods may improve the prediction of ventricular arrhythmias after myocardial infarction.
Yukinaka
M
M
Second Department of Internal Medicine, School of Medicine, University of Tokushima, Tokushima City, Japan.
Nomura
M
M
Ito
S
S
Nakaya
Y
Y
D019797:3-Iodobenzylguanidine; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine; D017256:Technetium Tc 99m Sestamibi