[Cardiac tomography with 99mTc-tetrofosmin after nitrate administration in patients with ischemic cardiopathy and left ventricular dysfunction].
OBJECTIVE
To investigate the role of technetium-99m (99mTc) tetrofosmin single-photon emission Computed Tomography (SPECT) associated with nitrate administration in the detection of hypoperfused but still viable myocardium in patients with chronic coronary artery disease and left ventricular (LV) dysfunction.


METHODS
Twenty-two patients (mean age 54 +/- 11 years) with coronary artery disease, previous myocardial infarction and LV dysfunction (LV ejection fraction 38 +/- 13%) were examined. On different days all patients underwent 99mTc tetrofosmin (740 MBq) SPECT under control conditions at rest and after sublingual nitroglycerin administration (10 mg). Regional tetrofosmin activity was quantitatively measured in 22 myocardial segments per patient. In each segment, tracer uptake was expressed as a percentage of the region with the peak activity.


RESULTS
Under control conditions, 267 myocardial segments (55%) showed normal tetrofosmin uptake (> 70% of peak activity), 107 segments (22%) showed a moderate reduction (51-70%) and 110 segments (23%) a severe reduction (< or = 50%) in tracer uptake. Among the 110 segments with a severe reduction in tetrofosmin uptake, 20 (18%) showed increased tracer uptake > or = 10% of after nitrate administration (from 44 +/- 5% to 58 +/- 3%, p < 0.0001). The remaining 90 (82%) segments with a severe reduction in tetrofosmin uptake did not show any change after nitroglycerin administration (from 38 +/- 9% to 39 +/- 8%, p = ns).


CONCLUSIONS
In patients with chronic coronary artery disease and LV dysfunction, tetrofosmin cardiac SPECT associated with sublingual nitrate administration allows the detection of severely hypoperfused but still viable myocardium.
Menna
F
F
Dipartimento di Scienze Biomorfologiche e Funzionali, Università Federico II, Napoli.
Acampa
W
W
Florimonte
L
L
Ferro
A
A
Borrelli
G
G
Mainolfi
C
C
Cuocolo
A
A
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D006321:Heart / Q000000981:diagnostic imaging* / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005996:Nitroglycerin; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D014665:Vasodilator Agents; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology
D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D014665:Vasodilator Agents; C078700:technetium tc-99m tetrofosmin; D005996:Nitroglycerin