Exercise β-Methyl Iodophenyl Pentadecanoic Acid (BMIPP) and Resting Thalium Delayed Single Photon Emission Computed Tomography (SPECT) in the Assessment of Ischemia and Viability
| Autor: | Masanori Hayakawa, Koujirou Awano, Takao Mori, Hisashi Fukuzaki, Kaoru Hattori, Tetsuya Inatome, Jun Masuda |
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| Rok vydání: | 1996 |
| Předmět: |
Male
medicine.medical_specialty Asynergy Physiology Rest Myocardial Infarction Myocardial Ischemia Ischemia Single-photon emission computed tomography Coronary Angiography Angina Pectoris Iodine Radioisotopes Coronary artery disease medicine.artery Internal medicine medicine Humans cardiovascular diseases Myocardial infarction Aged Tomography Emission-Computed Single-Photon medicine.diagnostic_test Iodobenzenes business.industry Fatty Acids Middle Aged medicine.disease Thallium Radioisotopes Stenosis medicine.anatomical_structure Right coronary artery Exercise Test Cardiology Female Cardiology and Cardiovascular Medicine Nuclear medicine business Artery |
| Zdroj: | Japanese Circulation Journal. 60:17-26 |
| ISSN: | 1347-4839 0047-1828 |
| Popis: | To clarify the significance of exercise BMIPP (beta-methyl iodophenyl pentadecanoic acid) and resting T1 delayed single photon emission computed tomography (SPECT) in the assessment of ischemia and viability, we studied maximal exercise-loading BMIPP SPECT following rest-injected T1 3 h SPECT in 11 control subjects, 20 patients with effort angina and 38 patients with old myocardial infarction. The left ventricular wall on ECT was divided into 9 segments. BMIPP and T1 uptake were scored as 0 = normal, 1 = reduced, 2 = severely reduced, or 3 = absent. Discordance was defined as when segments with a reduced BMIPP uptake had a better resting T1 uptake. Significant coronary artery stenosis was defined as stenosis of 75% or greater on coronary arteriogram. Left ventricular wall motion was assessed as either normokinesis, hypokinesis, severe hypokinesis, akinesis or dyskinesis on left ventriculogram. When discordance was considered to be a marker of ischemia, the sensitivity and specificity in effort angina and control subjects were 95.2% and 84.6% for patients and 83.9% and 94.4% for diseased vessels, respectively. There were no differences between the sensitivity and specificity in left anterior descending artery (LAD), left circumflex artery (LCx) and right coronary artery (RCA) lesions (83.3%, 95.5% in LAD, 83.3%, 95.5% in LCx, 85.7%, 92.6% in RCA, respectively). All of the patients with old myocardial infarction had reduced exercise BMIPP uptake in infarcted regions. In old myocardial infarction, 35 patients had segments with discordant uptake. Discordance was observed in 75 (91.5%) of 82 segments with hypokinesis, and in 24 (92.3%) of 26 segments with severe hypokinesis. Even among the 36 segments with akinesis or dyskinesis, 25 (69.0%) had discordant uptake. When discordance in the infarcted region was considered to be a marker of viability, regions with severe asynergy showed a high possibility of viability. Thus, discordant uptake on exercise BMIPP and resting T1 delayed SPECT may be a useful marker of ischemia in effort angina and of viability in old myocardial infarction. |
| Databáze: | OpenAIRE |
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