Nitrate-enhanced gated technetium 99m sestamibi SPECT for evaluating regional wall motion at baseline and during low-dose dobutamine infusion in patients with chronic coronary artery disease and left ventricular dysfunction: Comparison with two-dimensional echocardiography

Leoncini, Mario; Marcucci, Gabriella; Sciagrà, Roberto; Frascarelli, Fabio; Traini, Anna Maria; Mondanelli, D; Magni, Massimo; Bini, L; Bellandi, Francesco; Mennuti, A

doi:10.1067/mnc.2000.108029

Cited by 32 publications

(18 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The agreement in the classification of regional wall motion abnormalities, taking into account wall thickening data as well, is good to excellent, ranging form 56% to 91% [4,5]. Interestingly, even in patients with wide perfusion defects, such as those studied for the issue of myocardial viability in the setting of ischaemic cardiomyopathy, the accordance between gated SPECT and echocardiography appears satisfactory, with 68% agreement and a kappa statistics value of 0.54 [50]. Similar results have been reported by other authors [75].…”

Section: Value Of Gated Spect For Estimating Left Ventricular Functionmentioning

confidence: 95%

“…Although most software programs used for gated SPECT functional measurements work on threedimensional data, the possibility of inaccurate results, particularly underestimation of the ejection fraction, in left ventricles with an irregular shape and wide uptake defects must be considered [14,16]. In general the published reports indicate that the edge detection programs are able to correctly define the ventricular borders even in patients with severe hypoperfusion [5,26,50]. Most recent data suggest that gated SPECT could be a valuable method to assess abnormalities in left ventricular shape by means of a ventricular shape index [51].…”

Section: Gated Spect Techniquementioning

confidence: 99%

“…The reproducibility of gated SPECT regional wall motion assessment made it a reliable tool for evaluating the response to inotropic stimulation [6,50,103]. Low-dose dobutamine gated SPECT has become a reality with expanding fields of application.…”

Section: Gated Spect For the Assessment Of Contractile Reservementioning

confidence: 99%

See 2 more Smart Citations

The expanding role of left ventricular functional assessment using gated myocardial perfusion SPECT: the supporting actor is stealing the scene

Sciagrà

2007

Eur J Nucl Med Mol Imaging

View full text Add to dashboard Cite

Background Gating of single-photon emission computed tomography (SPECT) has significantly improved the reliability and diagnostic accuracy of myocardial perfusion imaging. The functional parameters derived from this technique, mainly left ventricular volumes and ejection fraction, have been demonstrated to be accurate and reproducible. They are able to increase the detection of severe and extensive coronary artery disease and show a significant incremental prognostic power over perfusion abnormalities. Therefore, the importance given to gated SPECT functional data has progressively grown. Discussion This circumstance has further expanded the indications for myocardial perfusion imaging and strengthened its position among the different imaging modalities. Moreover, several studies show that the evaluation of ventricular function may have a leading part in justifying the execution of perfusion scintigraphy in various clinical conditions. Aim Aim of this review is to describe this evolution of gated SPECT functional assessment from a supporting rank with respect to perfusion, to a main actor position in the field of cardiac imaging.

show abstract

Section: Value Of Gated Spect For Estimating Left Ventricular Functionmentioning

confidence: 95%

Section: Gated Spect Techniquementioning

confidence: 99%

See 1 more Smart Citation

The expanding role of left ventricular functional assessment using gated myocardial perfusion SPECT: the supporting actor is stealing the scene

Sciagrà

2007

Eur J Nucl Med Mol Imaging

View full text Add to dashboard Cite

show abstract

“…Regional wall motion was assessed visually by consensus of two blinded experienced observers and scored using a four-point scale (1=normal, 2=hypokine-sis; 3=akinesis; 4=dyskinesis) [16]. Previous data indicated a good reproducibility of these evaluations in our laboratory [17]. Segments that showed tracer uptake less than 30% of peak uptake were deemed unsuitable for regional functional analysis and were considered by definition to be akinetic [18].…”

Section: Study Protocolmentioning

confidence: 99%

Use of 99mTc-sestamibi gated SPECT to assess the influence of anterograde flow before primary coronary angioplasty on tissue salvage and functional recovery in acute myocardial infarction

Leoncini

Bellandi

Sciagrà

et al. 2004

Eur J Nucl Med Mol Imaging

View full text Add to dashboard Cite

Abstract.Purpose: Preserved thrombolysis in myocardial infarction (TIMI) flow before percutaneous coronary intervention (PCI) in acute myocardial infarction is related to improved outcome. Gated single-photon emission computed tomography (SPECT) allows the simultaneous assessment of left ventricular perfusion and function. We evaluated the initial risk area and subsequent evolution of perfusion and function according to TIMI flow before successful primary PCI. Methods: In 36 patients, treated with abciximab, primary PCI and stenting, 99m Tc-sestamibi was injected before PCI and gated SPECT acquired thereafter. Gated SPECT was repeated 7 and 30 days later. Perfusion defect, wall motion score index, left ventricular ejection fraction and volumes were examined. Results: Before PCI, 14 patients (group A) showed TIMI flow 2-3 and 22 (group B) TIMI flow 0-1, but no differences in clinical variables, initial risk area, wall motion score, ejection fraction or volumes. Perfusion defect was smaller in group A at 7 (9%±11% vs 19%±14%, p<0.02) and 30 days (7%±7% vs 16%±12%, p<0.02) and the salvage index was higher at 30 days (77%±22% vs 55%±28%, p<0.02). Wall motion score was lower in group A at 30 days (p<0.05). Ejection fraction significantly improved in both groups at 7 and 30 days. Enddiastolic volume showed a trend towards a reduction in group A, whilst it was significantly increased in group B. Conversely, end-systolic volume was significantly decreased in group A but remained unchanged in group B. Conclusion: In the setting of optimal myocardial reperfusion for myocardial infarction, preserved TIMI flow before PCI does not limit the initial risk area but it does improve myocardial salvage and functional recovery.

show abstract

“…2 Moreover, the acquisition of gated SPECT images during lowdose dobutamine (LDD) infusion permits the detection of contractile reserve in asynergic segments, 3 with results that are comparable to those of LDD echocardiography. 4 The combination of perfusion and functional data, including the assessment of contractile reserve, significantly improved the accuracy of nitrateenhanced technetium 99m sestamibi gated SPECT in detecting viable hibernating myocardium. 5 However, the value of this combined approach in comparison with a more established method such as LDD echocardiography is still unknown.…”

mentioning

confidence: 99%

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

Self Cite

View full text Add to dashboard Cite

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. (

show abstract

Nitrate-enhanced gated technetium 99m sestamibi SPECT for evaluating regional wall motion at baseline and during low-dose dobutamine infusion in patients with chronic coronary artery disease and left ventricular dysfunction: Comparison with two-dimensional echocardiography

Abstract: In patients with coronary artery disease who have LV dysfunction, nitrate-enhanced sestamibi gated SPECT allows a reliable WM evaluation, both at rest and during LDD infusion, in almost all segments and provides results in agreement with LDDE.

Cited by 32 publications

References 22 publications

The expanding role of left ventricular functional assessment using gated myocardial perfusion SPECT: the supporting actor is stealing the scene

The expanding role of left ventricular functional assessment using gated myocardial perfusion SPECT: the supporting actor is stealing the scene

Use of 99mTc-sestamibi gated SPECT to assess the influence of anterograde flow before primary coronary angioplasty on tissue salvage and functional recovery in acute myocardial infarction

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

Contact Info

Product

Resources

About