Severity and extent of perfusion defects provoked by transient coronary occlusion compared with myocardial damage observed after infarction.
A peripheral perfusion tracer injection at the time of coronary occlusion during percutaneous transluminal coronary angioplasty (PTCA) may delineate the myocardial 'area at risk' related to a given artery. To evaluate the location, size and severity of the corresponding scintigraphic defects, we conducted a prospective study of 36 patients who received a 99Tcm-sestamibi injection during single-vessel coronary angioplasty (PTCA = 18 LAD, 16 RCA and 2 LCX) followed by SPET. For comparison, a reference group of 36 successive patients examined during the early phase of myocardial infarction (MI), matched for the same vascular territories (18 anterior, 16 inferior and 2 lateral), were analysed in the same way after standard stress/reinjection 201Tl SPET. The imaging characteristics of both groups showed excellent agreement as well degree of uptake defects, in terms of topography and extent. A defect index, taking into account both size and severity, was in the same range for PTCA and MI patients (mean +/- standard deviation): for LAD vs anterior = 28.4 +/- 13.5% (PTCA), 27.1 +/- 12.2% (MI-stress) and 24.2 +/- 10.0% (MI-reinjection); for RCA vs inferior = 15.5 +/- 10.2% (PTCA), 14.7 +/- 9.7% (MI-stress) and 13.2 +/- 8.2% (MI-reinjection). Sectoral correlations between PTCA and MI groups were also highly significant.
Bontemps
L
L
Department of Nuclear Medicine, Cardiovascular Hospital, Lyon, France.
Gabain
M
M
Doudouh
A
A
Felecan
R
R
Ovize
M
M
Bonnefoy
E
E
Itti
R
R
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D009206:Myocardium / Q000473:pathology*; D011446:Prospective Studies; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012044:Regression Analysis; D012146:Rest; D017256:Technetium Tc 99m Sestamibi / Q000493:pharmacokinetics; D015899:Tomography, Emission-Computed, Single-Photon
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi