Prognostic value of an increased in flourine-18 deoxyglucose uptake in patients with myocardial infarction: Comparision with stress thallium imaging

Tamaki, Nagara; Kawamoto, Masahide; Takahashi, Norio; Yonekura, Yoshiharu; Magata, Yasuhiro; Nohara, Ryuji; Kambara, Hirofumi; Sasayama, Shígetake; Hirata, Kazuo; Ban, Toshihiko; Konishi, Junji

doi:10.1016/0735-1097(93)90586-p

Cited by 131 publications

(19 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Risk stratification in patients with LV ischemic dysfunction typically includes a combination of clinical, hemodynamic, and angiographic parameters. 17 Recent studies using myocardial metabolic imaging with positron emission tomography (PET) have indicated that assessing myocardial viability also provides useful prognostic information in these patients, [17][18][19][20][21] with an effect additive to that of the usual clinical assessment. 21 Whereas PET is expensive and not widely available, exercise-redistribution-reinjection thallium scintigraphy and dobutamine echocardiography are less expensive and potentially more widely available methods that can also distinguish viable from nonviable myocardium.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Myocardial Ischemia and Viability in Patients With Chronic Left Ventricular Ischemic Dysfunction

Pasquet¹,

Robert²,

D'hondt³

et al. 1999

Circulation

155

View full text Add to dashboard Cite

Background-Previous studies showed that thallium scintigraphy and dobutamine echocardiography were accurate, noninvasive ways of predicting contractile recovery after revascularization in patients with left ventricular (LV) dysfunction. However, the prognostic impact of such methods remains uncertain. Methods and Results-We prospectively studied 137 consecutive patients with coronary disease and LV dysfunction who underwent exercise-redistribution-reinjection thallium scintigraphy and dobutamine echocardiography to identify myocardial ischemia and viability. A total of 94 patients subsequently underwent revascularization, and 43 underwent medical treatment. The primary endpoint was cardiac mortality, and mean follow-up was 33Ϯ10 months. Twenty-four patients died of cardiac causes. By Cox's regression analysis, long-term survival was related to the extent of coronary disease, the presence of diabetes, type of treatment, the presence of ischemic myocardium as determined by thallium scintigraphy, and the presence of viable myocardium as determined by both tests. Three-year survival was greater in patients with ischemic myocardium (as determined by thallium scintigraphy) or viable myocardium (as determined by both tests) who underwent revascularization than in the other groups (Pϭ0.018 with thallium; PϽ0.001 with dobutamine). Subgroup analyses indicated that among patients with 1-or 2-vessel disease, only those with ischemic or viable myocardium improved survival after revascularization, whereas in patients with 3-vessel or left main diseases, revascularization always improved survival, albeit more in the presence of ischemic or viable myocardium. Conclusions-Among the parameters commonly available in patients with LV ischemic dysfunction, the presence of ischemic myocardium (as determined by thallium scintigraphy) and that of viable myocardium (as determined by dobutamine echocardiography) are independent predictors of subsequent mortality. These observations may be useful in the preoperative selection of patients for revascularization. (Circulation. 1999;100:141-148.)

show abstract

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Myocardial Ischemia and Viability in Patients With Chronic Left Ventricular Ischemic Dysfunction

Pasquet¹,

Robert²,

D'hondt³

et al. 1999

Circulation

155

View full text Add to dashboard Cite

show abstract

“…Both studies indicated that improvement in heart failure symptoms after revascularization occurred predominantly in patients with viable myocardium. Seven 18 F-FDG PET studies with 619 patients evaluated long-term prognosis in relation to treatment (medical and revascularization) and viability (absent or present) (27)(28)(29)(30)(31)(32)(33). Analysis of the pooled data demonstrated that the highest event rate was observed in patients who had viable myocardium and who were treated medically, whereas patients who had viable myocardium and who underwent revascularization had the best prognosis (Table 6).…”

Section: Nuclear Imaging By Pet With 18 F-fdgmentioning

confidence: 99%

Assessment of Myocardial Viability in Patients with Heart Failure

Schinkel¹,

Poldermans²,

Elhendy³

et al. 2007

Journal of Nuclear Medicine

134

View full text Add to dashboard Cite

The prognosis for patients with chronic ischemic left ventricular dysfunction is poor, despite advances in different therapies. Noninvasive assessment of myocardial viability may guide patient management. Multiple imaging techniques have been developed to assess viable and nonviable myocardium by evaluating perfusion, cell membrane integrity, mitochondria, glucose metabolism, scar tissue, and contractile reserve. PET, 201 Tl and 99m Tc scintigraphy, and dobutamine stress echocardiography have been extensively evaluated for assessment of viability and prediction of clinical outcome after coronary revascularization. In general, nuclear imaging techniques have a high sensitivity for the detection of viability, whereas techniques evaluating contractile reserve have a somewhat lower sensitivity and a higher specificity. MRI has a high diagnostic accuracy for assessment of the transmural extent of myocardial scar tissue. Patients with a substantial amount of dysfunctional but viable myocardium are likely to benefit from coronary revascularization and may show improvements in regional and global contractile function, symptoms, exercise capacity, and long-term prognosis.

show abstract

“…Even if some myocardial segments showed severe contractile dysfunction, left ventricular global and regional contractility may recover owing to viable segments. Non-invasive myocardial viability assessment thus has been considered important, and various approaches have been utilized including contractile functional reserve by echocardiography with inotropic stimulation, myocardial perfusion imaging with single-photon emission computed tomography (SPECT) and positron emission tomography with 18 F-fuluorodeoxyglucose (FDG) [1][2][3][4][5][6]. Although FDG may provide better diagnostic ability for detecting potentially reversible myocardial dysfunction, single-photon myocardial perfusion tracers continue to be one of the best convenient choices for clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Prediction of functional recovery after revascularization using quantitative gated myocardial perfusion SPECT: a multi-center cohort study in Japan

Nakajima

Tamaki

Kuwabara

et al. 2008

Eur J Nucl Med Mol Imaging

Self Cite

View full text Add to dashboard Cite

Backgrounds Prediction of left ventricular functional recovery is important after myocardial infarction. The impact of quantitative perfusion and motion analyses with gated single-photon emission computed tomography (SPECT) on predictive ability has not been clearly defined in multi-center studies. Methods A total of 252 patients with recent myocardial infarction (n=74) and old myocardial infarction (n=175) were registered from 25 institutions. All patients underwent resting gated SPECT using 99m Tc-MIBI, and repeated the study after revascularization after an average follow-up period of 132±81 days. Visual and quantitative assessment of perfusion and wall motion were performed in 5040 segments. Results Non-gated segmental %uptake and end-systolic (ES) %uptake were good predictors of wall motion recovery and significantly differed between improved and non-improved groups (66±17% and 55±18%, p<0.0001 for non-gated, 64±16% and 51±17% for ES %uptake, p<0.0001). The area under the curve (AUC) of receiver-operating characteristics curve (ROC) for non-gated %uptake, ES %uptake, end-diastolic (ED) %uptake and visual perfusion defect score was 0.70, 0.71, 0.61 and 0.56, respectively. Sensitivity and specificity of %uptake were 68% and 64% for non-gated map and 80% and 52% for ES %uptake map. An optimal threshold for predicting segmental improvement was 63% for non-gated and 52% for ES %uptake values. Conclusion Segmental 99m Tc-MIBI uptake provided a useful predictor of wall motion improvement. Application of quantitative approach with non-gated and ES %uptake enhanced predictive accuracy over visual analysis particularly in a multi-center study.

show abstract

Prognostic value of an increased in flourine-18 deoxyglucose uptake in patients with myocardial infarction: Comparision with stress thallium imaging

Cited by 131 publications

References 36 publications

Prognostic Value of Myocardial Ischemia and Viability in Patients With Chronic Left Ventricular Ischemic Dysfunction

Prognostic Value of Myocardial Ischemia and Viability in Patients With Chronic Left Ventricular Ischemic Dysfunction

Assessment of Myocardial Viability in Patients with Heart Failure

Prediction of functional recovery after revascularization using quantitative gated myocardial perfusion SPECT: a multi-center cohort study in Japan

Contact Info

Product

Resources

About