Myocardial viability index in chronic coronary artery disease: Technetium- 99m-methoxy isobutyl isonitrile redistribution

S. Maurea, A. Cuocolo, A. Soricelli, L. Castelli, F. Squame, M. Imbriaco, N. De Luca, B. Trimarco, M. Salvatore

Research output: Contribution to journalArticle

Abstract

The purpose of this study was to evaluate whether an additional redistribution image after a rest 99mTc-MIBI injection enhances detection of viable myocardium and predicts functional recovery after coronary revascularization in patients with chronic coronary artery disease (CAD). Methods: Thirty-one patients (29 men, mean age 55 ± 10 yr) with proven CAD and left ventricular (LV) dysfunction (ejection fraction 39% ± 9%) underwent resting 99mTc-MIBI tomography with initial (1 hr) and delayed (5 hr) images. Within 1 wk of MIBI imaging, all patients underwent rest- redistribution 201Tl imaging. Eight patients also underwent two- dimensional echocardiography before and 5 ± 3 mo after coronary revascularization. Results: On the initial 99mTc-MIBI images, 302 myocardial segments were normal, 183 showed moderate and 197 severe reduction of tracer uptake. Of these 197 segments, 47 (24%) demonstrated increased tracer uptake (≥10% versus initial) on delayed images (from 43% ± 8% to 60% ± 8%, p99mTC-MIBI redistribution. These 47 segments were observed in 20 (65%) patients in whom 201Tl images detected viable myocardium in the same segments. In the eight patients studied before and after revascularization, 83% of segments with 99mTc- MIBI redistribution and abnormal LV function showed functional recovery after revascularization, while 96% of segments without 99mTc-MIBI redistribution did not show functional recovery. Conclusion: Resting 99mTc-MIBI redistribution frequently occurs in patients with chronic CAD. Acquisition of 99mTc-MIBI redistribution images enhances detection of viable myocardium and predicts functional recovery after revascularization.

Original languageEnglish
Pages (from-to)1953-1960
Number of pages8
JournalJournal of Nuclear Medicine
Volume36
Issue number11
Publication statusPublished - 1995

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Keywords

  • functional recovery
  • left ventricular dysfunction
  • technetium-99m-sestamibi
  • thallium-201

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Maurea, S., Cuocolo, A., Soricelli, A., Castelli, L., Squame, F., Imbriaco, M., De Luca, N., Trimarco, B., & Salvatore, M. (1995). Myocardial viability index in chronic coronary artery disease: Technetium- 99m-methoxy isobutyl isonitrile redistribution. Journal of Nuclear Medicine, 36(11), 1953-1960.