Influence of the assessment of defect severity and intravenous nitrate administration during tracer injection on the detection of viable hibernating myocardium with data-based quantitative technetium 99m-labeled sestamibi single-photon emission computed tomography

Roberto Sciagrà, Gianni Bisi, Giovanni M. Santoro, Marco Agnolucci, Orazio Zoccarato, Pier Filippo Fazzini

Research output: Contribution to journalArticle


Background. This study aimed to verify whether the assessment of defect severity and the infusion of nitrates during tracer injection improve the capability of data-based 99mTc-labeled sestamibi single-photon emission computed tomography (SPECT) to recognize hibernating myocardium. Methods and Results. Of 66 asynergic coronary territories in 40 patients with left ventricular dysfunction, 28 had postrevascularization functional recovery (hibernating) and 38 had unchanged dysfunction (fibrotic). Defect severity was lower in the hibernating than in the fibrotic territories on both baseline (p <0.01) and nitrate SPECT (p <0.002). Nitrate was superior to baseline SPECT to differentiate the hibernating from the fibrotic territories (sensitivity 96% vs 75%, p <0.05; receiver-operating characteristic curve area 0.75 vs 0.63, p <0.001) and to identify the patients with improved left ventricular ejection fraction (receiver-operating characteristic curve area 0.68 vs 0.58; p <0.05). Conclusions. The analysis of defect severity in combination with nitrate infusion clearly improves the value of 99mTc-labeled sestamibi SPECT for the recognition of hibernating myocardium and the prediction of postrevascularization recovery.

Original languageEnglish
Pages (from-to)221-230
Number of pages10
JournalJournal of Nuclear Cardiology
Issue number3
Publication statusPublished - May 1996



  • Myocardial viability
  • Nitrates
  • Sestamibi

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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