Background: Whether the combined analysis of rest 201Tl and sestamibi uptake provides additional information regarding myocardial viability in patients with coronary artery disease is still to be investigated. Methods and Results: To this aim we studied 22 patients with previous myocardial infarction and regional ventricular dysfunction by quantitative rest sestamibi and 201Tl scintigraphy. All patients underwent revascularization, and echocardiography was repeated 11±2 weeks later. Concordant results were obtained in 80 of 105 dyssynergic segments. Fifty-one segments showed normal and 29 abnormal activity. Follow-up echocardiography showed increased wall motion contractility in 76% of segments with maintained 201Tl and sestamibi uptake and in only 17% of segments characterized by subthreshold activities. Twenty-five segments, or 24%, showed sestamibi/201Tl mismatch. Eleven of 12 segments with normal sestamibi/abnormal 201Tl activity did not improve after revascularization, whereas 11 of 13 segments with abnormal sestamibi but normal 201Tl showed postoperative improvement of regional wall motion. Conclusions: In patients with previous myocardial infarction, sestamibi and 201Tl showed concordant results in most segments. However, in segments with mismatch a maintained sestamibi uptake was a poor indicator of tissue viability, whereas significant 201Tl uptake reflected tissue viability in most segments.
- sestamibi scintigraphy
- thallium 201 scintigraphy
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine