Comparative study for the identification of myocardial ischemia by contrast ventriculography under the effect of isosorbide mononitrate and by perfusional myocardial scintigraphy in patients with ischemic heart disease.
OBJECTIVE
To evaluate and compare the usefulness of cineventriculographies, before and after nitrate use, to technetium-99m sestamibi scintigraphy for the identification of myocardial ischemia.


METHODS
Twenty-six patients were studied at basal conditions and 5 minutes after intravenous administration of isosorbide mononitrate (0.3 mg/kg), to evaluate the performance and regional wall motion of the left ventricle (LV). The results were compared too those obtained with technetium-99m sestamibi scintigraphy.


RESULTS
Before nitrate, contrast ventriculography identified 30 normal segments, 62 hypokinetic segments, 28 dyskinetic segments, and 14 akinetic segments. After drug administration, 99 segments were normal, 11 hypokinetic, 11 dyskinetic, and 13 akinetic. Myocardial scintigraphy revealed 110 ischemic segments and 18 fibrotic segments (p < 0.005). After drug administration, the ventriculography showed increase in the velocity of circumferential fiber shortening (p = 0.0142), the ejection fraction (p = 0.0462), decrease in the end-systolic volume (p = 0.0031) and no change in end-diastolic volume.


CONCLUSIONS
Contrast ventriculography using nitrate proved to be similar to perfusional myocardial scintigraphy in the identification of myocardial ischemia.
Manfroi
W C
WC
Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Ludwig
R
R
Kirschnick
L S
LS
Souza
J
J
Ribeiro
L W
LW
Ordovás
K
K
Leitão
C
C
Cruz
R
R
Candiago
R
R
D005260:Female; D006801:Humans; D007548:Isosorbide Dinitrate / Q000031:analogs & derivatives* / Q000494:pharmacology; D008297:Male; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging*; D015635:Radionuclide Ventriculography; D017256:Technetium Tc 99m Sestamibi; D014665:Vasodilator Agents / Q000494:pharmacology*; D016277:Ventricular Function, Left / Q000502:physiology
D014665:Vasodilator Agents; D017256:Technetium Tc 99m Sestamibi; D007548:Isosorbide Dinitrate; C030397:isosorbide-5-mononitrate