[Heart tomography with 99mTc sestamibi and echocardiography with dobutamine in the identification of reversible left ventricular dysfunction in patients with acute myocardial infarction].
BACKGROUND
We investigated the role of technetium-99m (99mTc) sestamibi cardiac imaging and dobutamine echocardiography in detecting myocardial viability early after acute myocardial infarction.


METHODS
Nineteen patients (mean age 52 +/- 10 years) underwent coronary angiography, low-dose dobutamine echocardiography and rest 99mTc sestamibi imaging within 10 days of myocardial infarction. All patients were revascularized. Resting echocardiogram was repeated 8 months later to evaluate segmental functional recovery.


RESULTS
Sixty-one of 108 akinetic or dyskinetic segments at baseline showed functional recovery after revascularization. Sensitivity in predicting segmental functional recovery was 87% for sestamibi imaging and 66% for dobutamine echocardiography (p < 0.001), while specificity and accuracy were comparable. Sestamibi activity was the strongest predictor of segmental functional recovery (p < 0.001).


CONCLUSIONS
Dobutamine echocardiography predicts functional recovery after myocardial infarction. However, sestamibi imaging is useful to identify patients with dysfunctional segments without contractile reserve which may benefit by revascularization.
Gisonni
P
P
Dipartimento di Scienze Biomorfologiche e Funzionali, Università Federico II, Napoli.
Cuocolo
A
A
Spinelli
L
L
Acampa
W
W
Florimonte
L
L
Nicolai
E
E
Petretta
M
M
Sodano
A
A
D002316:Cardiotonic Agents; D004280:Dobutamine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology
D002316:Cardiotonic Agents; D019275:Radiopharmaceuticals; D004280:Dobutamine; D017256:Technetium Tc 99m Sestamibi
Tomografia cardiaca con 99mTc sestamibi ed ecocardiografia con dobutamina nell'identificazione della disfunzione ventricolare sinistra reversibile nei pazienti con infarto acuto del miocardio.