[Comparative study of 18 F-fluorodeoxyglucose imaging with a dual-head coincidence gamma camera with dobutamine stress echocardiography for the assessment of myocardial viability].
OBJECTIVE
To compare Dual-Head coincidence gamma camera (DCD-AC) with dobutamine stress echocardiography (DSE) in viability assessment, using functional recovery as the gold standard.


METHODS
Twenty-one patients were prospectively studied, with coronary artery disease and severe left ventricular dysfunction undergoing DSE and DCD-AC at baseline and DSE three months after revascularization.


RESULTS
Of the 290 segments analyzed, 83% were akinetic, 15% hypokinetic and 2% dyskinetic at rest. DSE identified 68% of these segments as non-viable. DCD-AC identified 56% of these segments as normal (dysfunctional segments with preserved metabolism and perfusion), 30% as viable (preserved metabolism and reduced perfusion) and 14% as non-viable (reduced perfusion and metabolism). Of the DSE non-viable segments, DCD-AC identified 80% as normal or viable and 19.9% as non-viable (p<0.001). In hypokinetic segments viability and normal segments were detected in a higher proportion by both methods (p<0.001). DSE sensibility and specificity were 48.3% and 78.1% respectively. DCD-AC sensibility and specificity was 92.2% and 20.0%. DCD-AC identifies a higher incidence of function improvement in normal segments than in viable and non-viable.


CONCLUSIONS
DCD-AC classified as normal or viable most of the non-viable DSE segments. In assessment of functional recovery segments after three months, DCD-AC showed a high sensibility but low specificity.
Farsky
Pedro Silvio
PS
Instituto Dante Pazzanese de Cardiologia e Fleury, Centro de Medicina Diagnóstica, São Paulo, SP. farskyp@uol.com.br
Piegas
Leopoldo Soares
LS
Gimenes
Vera Marcia
VM
Petisco
Ana Claudia G
AC
Duarte
Paulo S
PS
Martins
Luiz Roberto
LR
Issa
Mario
M
Paulista
Paulo Paredes
PP
Sousa
José Eduardo Moraes Rego
JE
D025401:Echocardiography, Stress; D004812:Epidemiologic Methods; D005260:Female; D019788:Fluorodeoxyglucose F18; D015902:Gamma Cameras; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000601:surgery; D009204:Myocardial Revascularization; D019275:Radiopharmaceuticals; D014055:Tomography, Emission-Computed; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000601:surgery
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18