Assessment of myocardial washout of Tc-99m-sestamibi in patients with chronic heart failure: comparison with normal control.
BACKGROUND
In contrast to 201TlCl, 99mTc-sestamibi shows very slow myocardial clearance after its initial myocardial uptake. In the present study, myocardial washout of 99mTc-sestamibi was calculated in patients with non-ischemic chronic heart failure (CHF) and compared with biventricular parameters obtained from first-pass and ECG-gated myocardial perfusion SPECT data.


RESULTS
After administration of 99mTc-sestamibi, 25 patients with CHF and 8 normal controls (NC) were examined by ECG-gated myocardial perfusion SPECT and planar data acquisition in the early and delayed (interval of 3 hours) phase. Left ventricular ejection fraction (LVEF, %), peak filling rate (PFR, sec(-1)), end-diastolic volume (LVEDV, ml) and end-systolic volume (LVESV, ml) were automatically calculated from the ECG-gated SPECT data. Myocardial washout rates over 3 hours were calculated from the early and delayed planar images. Myocardial washout rates in the CHF group (39.6+/-5.2%) were significantly higher than those in the NC group (31.2+/-5.5%, p < 0.01). The myocardial washout rates for the 33 subjects showed significant correlations with LVEF (r = -0.61, p < 0.001), PFR (r = -0.47, p < 0.01), LVEDV (r = 0.45, p < 0.01) and LVESV (r = 0.48, p < 0.01).


CONCLUSIONS
The myocardial washout rate of 99Tc-sestamibi is considered to be a novel marker for the diagnosis of myocardial damage in patients with chronic heart failure.
Department of Radiology, Nippon Medical School, Tokyo, Japan. s-kumita@nms.ac.jp
Shin-ichiro
S
Kumita
Yoshihiko
Y
Seino
Keiichi
K
Cho
Hidenobu
H
Nakajo
Masahiro
M
Toba
Yoshimitsu
Y
Fukushima
Noriake
N
Okamoto
Teruo
T
Takano
Tatsuo
T
Kumazaki
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D015637:Gated Blood-Pool Imaging; D006333:Heart Failure / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000378:metabolism*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000378:metabolism; D006801:Humans; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D013318:Stroke Volume; D017256:Technetium Tc 99m Sestamibi / Q000493:pharmacokinetics*; D015899:Tomography, Emission-Computed, Single-Photon; D015646:Ventriculography, First-Pass
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi