title: Quantitative evaluation of myocardial perfusion in patients with revascularized myocardial infarction: comparison between intravenous myocardial contrast echocardiography and 99mTc-sestamibi single photon emission computed tomography.
abstract: OBJECTIVE
  This two-center study compared quantitative segmental perfusion mapping by intravenous myocardial contrast echocardiography (ivMCE) and scintigraphy (SPECT) in patients in the subacute phase of myocardial infarction (AMI).
  
  
  RESULTS
  Sixteen patients underwent ivMCE using 1:1 intermittent harmonic imaging 24 h after first AMI treated with PTCA and stenting. Apical contrast echocardiograms were obtained after the injections of Sonazoid. Baseline-corrected peak myocardial videointensity (bcPMVI) was determined automatically in 16 segments. Resting 99mTc-sestamibi SPECT was performed within one day after ivMCE. SPECT images were reoriented matching the ivMCE views, and divided into the same segments as in ivMCE, from which mean count rate values were obtained. After exclusion due to artifacts or attenuation, 208/256 (82%) segments remained for analysis. Normalized SPECT count rate and bcPMVI correlated linearly: bcPMVI = 1.237 x SPECT - 35; r = 0.74, p < 0.0001. The relation remained identical in subgroup analysis based on participating center, echocardiographic view, perfusion territory, infarct zone, or function. Using SPECT as reference, mean bcPMVI was 77+/-19% in normal segments, 53+/-29% in mild-moderate defects and 25+/-18% in severe defects (p<0.001 for all comparisons).
  
  
  CONCLUSIONS
  The videointensity increase observed in quantitative ivMCE clearly correlated with SPECT tracer uptake. This further substantiates the use of ivMCE as a valid technique for myocardial perfusion imaging.
authors.affiliation: Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands. gtj.sieswerda@vumc.nl
authors.forename: Gertjan Tj
authors.initials: GT
authors.lastname: Sieswerda
authors.forename: Lucas J
authors.initials: LJ
authors.lastname: Klein
authors.forename: Otto
authors.initials: O
authors.lastname: Kamp
authors.forename: Eric A
authors.initials: EA
authors.lastname: Aiazian
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Lepper
authors.forename: Frans C
authors.initials: FC
authors.lastname: Visser
authors.forename: Peter
authors.initials: P
authors.lastname: Hanrath
authors.forename: Cees A
authors.initials: CA
authors.lastname: Visser
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D001783:Blood Flow Velocity; D003326:Coronary Circulation / Q000502:physiology*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000628:therapy; D015425:Myocardial Reperfusion / Q000379:methods; D011336:Probability; D012372:ROC Curve; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D017256:Technetium Tc 99m Sestamibi