[Efficacy of stress-rest myocardial SPET with 99mTc-MIBI in predicting recovery of postrevascularization contractile function. Results of the Spanish multicenter protocol. Working Group of Nuclear Cardiology].
OBJECTIVE
The aim of this study was to evaluate the efficacy of stress-rest 99mTc-MIBI SPET to predict wall motion improvement after revascularization.


METHODS
A prospective and consecutive series of 82 patients (59 +/- 9 years, 12 women), who had some segment with severe impairment of the contractility and underwent coronary revascularization by surgery (n = 64) or angioplasty (n = 18) were studied with rest 99mTc-MIBI SPET. All patients had a rest 99Tc-MIBI SPET, and an exercise test was also performed on 40 of these patients. Before and within 3-6 months after the revascularization a gated blood pool scintigraphy of three projections was performed. The segmentary contractile recovery after revascularization was assessed in relation to the quantification of the 99mTc-MIBI uptake and to the exercise-rest reversibility (exercise uptake < rest uptake).


RESULTS
The mean value of the left ejection fraction did not change after the revascularization (41.1 +/- 14.5% vs 41.8 +/- 15.7%). In the post revascularization control a contractile recovery was observed in 40% (113/282) of the segments with severe hypokinesia, akinesia or dyskinesia. Exercise-rest reversibility and rest uptake > 30% were present in 62% (p = 0.002) and 89% (p < 0.0001) respectively of segments that improved contractility after revascularization.


CONCLUSIONS
For the 99mTc-MIBI SPET an exercise-rest reversibility and > 30% uptake at rest are predictive criteria of contractile recovery after revascularization.
Candell-Riera
J
J
Servei de Cardiologia, Hospital General Universitari Vall d'Hebron, Barcelona. jcandell@hg.vhebron.es
Castell-Conesa
J
J
González
J M
JM
Rosselló-Urgell
J
J
D005080:Exercise Test; D005260:Female; D015637:Gated Blood-Pool Imaging; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D009204:Myocardial Revascularization; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi