Correlation of left ventricular dyssynchrony with myocardial stunning using dual single photon emission computed tomography of (123)iodine-beta-methyl iodophenyl pentadecanoic acid and (201)thallium scintigraphy after reperfusion therapy.
OBJECTIVE
Left ventricular (LV) dyssynchrony after reperfusion therapy has been closely examined as a cause of chronic remodeling, but the details have not been clarified. The present study measured LV dyssynchrony appearing immediately after reperfusion therapy using real-time three-dimensional echocardiography (RT-3DE), and assessed the significance of this phenomenon in relation to dual single photon emission computed tomography (SPECT) of (123)iodine beta methyliodophenyl pentadecanoic acid ((123)I-BMIPP) and (201)thallium ((201)Tl).


METHODS
Subjects comprised 58 patients with first-time acute myocardial infarction who received reperfusion therapy and underwent RT-3DE and dual SPECT of (123)I-BMIPP and (201)Tl within two weeks of onset. Two dyssynchrony parameters were measured using RT-3DE in the acute phase and six months later. After evaluating the correlation of these dyssynchrony parameters to resting (201)Tl uptake, (201)Tl washout, (123)I-BMIPP uptake, and (201)Tl-(123)I-BMIPP discrepancy (Tl-BMIPP discrepancy), we compared scintigraphic parameters in the chronic phase between groups with improved dyssynchrony and those without.


RESULTS
Acute dyssynchrony exhibited a significant positive correlation to Tl-BMIPP discrepancy and it was significantly increased in the group with improved dyssynchrony in the chronic phase, revealing close relationship between dyssynchrony and Tl-BMIPP discrepancy. Then the subjects were divided into positive Tl-BMIPP discrepancy and negative discrepancy groups, and the parameters of cardiac function were compared between them. In the chronic phase, improved cardiac function was observed in the group with positive Tl-BMIPP discrepancy compared to negative discrepancy.


CONCLUSIONS
LV dyssynchrony after reperfusion therapy correlates positively with Tl-BMIPP discrepancy, reflecting acute myocardial stunning, in which ventricular contraction improves during the chronic phase.
Department of Health Promotion, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan. ymaru@saitama-med.ac.jp
Yoshiaki
Y
Maruyama
Nobuyuki
N
Masaki
Yuji
Y
Shimizu
Norinari
N
Honda
Nobuo
N
Yoshimoto
D005227:Fatty Acids; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D017682:Myocardial Stunning / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000628:therapy; D015424:Reperfusion; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy
D005227:Fatty Acids; D007462:Iodobenzenes; D013794:Thallium Radioisotopes; C049338:iodofiltic acid