Value of rest thallium-201/technetium-99m sestamibi scans and dobutamine echocardiography for detecting myocardial viability

Paolo Marzullo, Oberdan Parodi, Barbara Reisenhofer, Gianmario Sambuceti, Eugenio Picano, Alessandro Distante, Alessia Gimelli, Antonio L'Abbate

Research output: Contribution to journalArticle

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Abstract

The relation between radioisotopic and echocardiographic markers of myocardial viability and postrevascularization recovery of function is still to be defined. To this purpose, 14 patients (11 men, 3 women, aged 35 to 64 years, mean 54 ± 7) with ventricular dysfunction were studied by a multiparametric approach. Each patient underwent, on separate days, rest thallium-201 and technetium-99m sestamibi scintigraphy, dobutamine echocardiography and coronary angiography. Coronary angiography was analyzed by a quantitative approach. Thallium uptake at rest was quantified from planar early (10-minute) and delayed (16-hour) thallium-201 images and expressed as a percentage of maximal activity in each projection using a 13-segment model. Sestamibi uptake was expressed in the same way. Dobutamine (up to 10 μg/kg/min) echocardiography was analyzed using a score index ranging from 1 (normokinesia) to 4 (dyskinesia) and a similar segmental model. Before revascularization 50 segments were grouped as normal (coronary stenosis 50% coronary stenosis, 57 had normal wall motion (group 2) and 75 showed regional dyssynergies (group 3). Early and delayed thallium-201 regional percent activities did not differ in group 1 and in group 2 but were significantly less in group 3 segments. Sestamibi percent activity was more in group 1 and significantly reduced both in group 2 and 3 segments. Segments with improved wall motion after dobutamine had more early, delayed thallium-201 and sestamibi percent activities than unresponsive segments. Postrevascularization echocardiography was performed in all patients. Delayed thallium-201 scans and dobutamine echocardiography showed good sensitivity and specificity in detecting viable myocardium. It is concluded that: (1) rest-injected, delayed thallium-201 scan provides a good preoperative characterization of viable myocardium; (2) sestamibi does not differentiate dyssynergic from normal segments in territories supplied by stenotic coronary arteries; and (3) dobutamine echocardiography is similar to delayed thallium-201 scintigraphy in predicting myocardial viability.

Original languageEnglish
Pages (from-to)166-172
Number of pages7
JournalThe American Journal of Cardiology
Volume71
Issue number2
DOIs
Publication statusPublished - Jan 15 1993

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Technetium Tc 99m Sestamibi
Dobutamine
Thallium
Echocardiography
Coronary Stenosis
Coronary Angiography
Radionuclide Imaging
Myocardium
Ventricular Dysfunction
Recovery of Function
Dyskinesias
Coronary Vessels
Sensitivity and Specificity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Value of rest thallium-201/technetium-99m sestamibi scans and dobutamine echocardiography for detecting myocardial viability. / Marzullo, Paolo; Parodi, Oberdan; Reisenhofer, Barbara; Sambuceti, Gianmario; Picano, Eugenio; Distante, Alessandro; Gimelli, Alessia; L'Abbate, Antonio.

In: The American Journal of Cardiology, Vol. 71, No. 2, 15.01.1993, p. 166-172.

Research output: Contribution to journalArticle

Marzullo, Paolo ; Parodi, Oberdan ; Reisenhofer, Barbara ; Sambuceti, Gianmario ; Picano, Eugenio ; Distante, Alessandro ; Gimelli, Alessia ; L'Abbate, Antonio. / Value of rest thallium-201/technetium-99m sestamibi scans and dobutamine echocardiography for detecting myocardial viability. In: The American Journal of Cardiology. 1993 ; Vol. 71, No. 2. pp. 166-172.
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AU - Sambuceti, Gianmario

AU - Picano, Eugenio

AU - Distante, Alessandro

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AU - L'Abbate, Antonio

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