Assessment of myocardial viability by dobutamine echocardiography, positron emission tomography and thallium-201 SPECT

Baumgartner, Helmut; Porenta, Gerold; Lau, Yuk-Kong; Wutte, Michael; Klaar, Ursula; Mehrabi, Mohammad Reza; Siegel, Robert J.; Czernin, Johannes; Laufer, Günther; Sochor, Heinz; Schelbert, Heinrich R.; Fishbein, Michael C.; Maurer, Gerald

doi:10.1016/s0735-1097(98)00436-7

Cited by 112 publications

(46 citation statements)

References 25 publications

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“…11,12 Histopathologic observations in explanted hearts suggest that cellular integrity and contractile reserve provide complementary data for the assessment of tissue viability. 13 These findings have been confirmed in clinical settings. The combined evaluation of rest-redistribution thallium 201 and LDD echocardiography significantly enhanced the identification of viable myocardium in patients with chronic coronary artery disease.…”

Section: Discussionmentioning

confidence: 70%

Low-dose dobutamine nitrate-enhanced technetium 99m sestamibi gated SPECT versus low-dose dobutamine echocardiography for detecting reversible dysfunction in ischemic cardiomyopathy

Leoncini

2002

Journal of Nuclear Cardiology

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Background. The simultaneous assessment of perfusion and function with the use of technetium 99m sestamibi gated single photon emission computed tomography (SPECT) is helpful for the detection of myocardial viability, but its value in comparison with more established methods is not yet defined.Methods and Results. This study compared low-dose dobutamine (LDD) nitrate-enhanced gated SPECT with LDD echocardiography for predicting recovery of regional ventricular function after revascularization in 25 patients with ischemic cardiomyopathy. In both studies, regional function (wall motion and thickening) at rest, during inotropic stimulation, and after revascularization was scored by a 4-point scale. In LDD echocardiography, the prediction of reversible dysfunction was based on the recognition of contractile reserve in asynergic (hypokinetic or a-dyskinetic) segments. In LDD gated sestamibi SPECT, reversible dysfunction was predicted on the basis of perfusion quantification (sestamibi uptake > 50%) in a-dyskinetic segments and on the basis of contractile reserve in hypokinetic segments. LDD echocardiography predicted reversible dysfunction with sensitivity, specificity, and global accuracy of 57%, 85%, and 75%, respectively. The sensitivity and specificity of LDD gated SPECT for identifying dysfunctional segments capable of functional recovery were 77% and 88%, respectively, with a diagnostic accuracy of 84% (P < .02 vs LDD echocardiography).Conclusions. The combined use of 2 different markers of viability, such as cellular integrity in a-dyskinetic segments and contractile reserve in hypokinetic segments, as permitted by LDD gated sestamibi SPECT, showed higher predictive accuracy for reversible dysfunction than the assessment of contractile reserve in all asynergic segments with LDD echocardiography. (

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Section: Discussionmentioning

confidence: 70%

Low-dose dobutamine nitrate-enhanced technetium 99m sestamibi gated SPECT versus low-dose dobutamine echocardiography for detecting reversible dysfunction in ischemic cardiomyopathy

Leoncini

2002

Journal of Nuclear Cardiology

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“…They generally show little improvement in wall motion with DSE and do not improve after revascularization. [22][23][24][25] Dobutamine echocardiography evaluates contractile reserve as a predictor of improvement of ventricular function, and like radionuclide techniques, general agreement exists about its predictive accuracy (class I). 20 Myocardial contrast echocardiography uses acoustically active gas-filled microbubbles as contrast agent that have a diameter smaller than red blood cells (Ͻ7 m) and remain confined within the intravascular space.…”

Section: Assessment Of Viabilitymentioning

confidence: 99%

Stunning, Hibernation, and Assessment of Myocardial Viability

2008

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“…However, due to their limited spatial resolution, these tools only provide an 'all' or 'nothing' result for myocardial activity (14). Notably, even in a single myocardial segment, there may be both viable and unviable parts, for example, the outer membrane of an endocardium with myocardial infarction may be viable.…”

Section: Discussionmentioning

confidence: 99%

Assessment of myocardial viability with delayed-enhancement MRI in coronary artery disease: A correlative study with coronary artery stenosis using digital subtraction angiography

Zhao

Zhang

Sun

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to investigate the correlation between the degree of coronary artery stenosis determined by digital subtraction angiography (DSA) and infarcted segments detected by delayed enhancement magnetic resonance imaging (DE-MRI). DE-MRI and DSA were performed in 40 patients with coronary artery disease. The number of myocardial segments with infarction, the transmural extent of myocardial infarction, score of myocardial infarction by MRI, degree of coronary artery stenosis and Gensini score of the coronary artery were assessed. The correlation was analyzed using Spearman's rank correlation test. Among the 40 patients, 126 infarcted myocardial segments with a total score of 307 were found by DE-MRI; the total Gensini score for coronary artery stenosis was 587. It was observed that 81.74% of the infarcted segments were at sites with >50% coronary artery stenosis. The correlation coefficient between the Gensini score and myocardial infarction score was 0.786 (P<0.001), indicating a good correlation. However, 18.26% of myocardial infarction segments were found in patients with slight coronary artery stenosis (≤25%). A correlation was identified between DSA detected coronary artery stenosis and infarcted segments detected by DE-MRI; a higher transmural extent of myocardial infarction correlated with more severe stenosis of the coronary artery. The combined use of the two tools may facilitate accurate diagnosis.

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Assessment of myocardial viability by dobutamine echocardiography, positron emission tomography and thallium-201 SPECT

Cited by 112 publications

References 25 publications

Low-dose dobutamine nitrate-enhanced technetium 99m sestamibi gated SPECT versus low-dose dobutamine echocardiography for detecting reversible dysfunction in ischemic cardiomyopathy

Low-dose dobutamine nitrate-enhanced technetium 99m sestamibi gated SPECT versus low-dose dobutamine echocardiography for detecting reversible dysfunction in ischemic cardiomyopathy

Stunning, Hibernation, and Assessment of Myocardial Viability

Assessment of myocardial viability with delayed-enhancement MRI in coronary artery disease: A correlative study with coronary artery stenosis using digital subtraction angiography

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