Linked Life Data

11233551

Source:http://linkedlifedata.com/resource/pubmed/id/11233551

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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
2001-3-6
pubmed:abstractText
In myocardial perfusion scintigraphy, the clinical significance of fixed defects presents some difficulty. In this study, we evaluated whether additional information on left ventricular function assessed by quantitative gated single-photon emission computed tomography (gated SPET) would increase the diagnostic yield of the study in such patients. We studied 55 patients with a previous myocardial infarction and 20 patients without a previous myocardial infarction using gated SPET 99Tc(m)-tetrofosmin myocardial perfusion imaging. Each patient had to have a persistent perfusion defect consisting of at least three contiguous segments in the same vascular territory. The left ventricle was divided into 20 segments which were analysed for perfusion and wall thickening on a 4-point severity scale. Of the 55 patients with myocardial infarction, 19 (35%) patients showed preserved wall thickening in the region of the previous infarction with fixed perfusion abnormalities, which suggested residual myocardial viability. In the 20 patients without myocardial infarction, preserved wall thickening was seen in 10 (50%) patients with fixed perfusion defects, suggesting an attenuation artefact. Conversely, in 16 (29%) patients in the myocardial infarction group and two (10%) patients in the non-myocardial infarction group normal perfusion was associated with severely diminished wall thickening possibly due to stunning. We found an excellent correlation between wall thickening and left ventricular ejection fraction both for the patients with myocardial infarction and the patients without myocardial infarction (r = 0.86 and r = 0.82, respectively, both P<0.0001). A reasonable correlation between perfusion and left ventricular ejection fraction was found for the patients with myocardial infarction (r = 0.41, P = 0.002), and a non-significant correlation for the patients without myocardial infarction (r = 0.37, P = 0.1). Quantitative gated SPET myocardial imaging allows the detection of residual wall thickening in patients with a previous myocardial infarction who show severe fixed perfusion defects. In patients without myocardial infarction, gated SPET imaging allows differentiation between an attenuation artefact and a fixed perfusion defect due to coronary artery disease. In addition, gated SPET may show diminished ventricular function in normally perfused segments possibly due to myocardial stunning. The addition of gated SPET myocardial perfusion imaging increases diagnostic confidence and may have direct clinical implications for optimal patient management.
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jan
pubmed:issn
0143-3636
pubmed:author
pubmed:issnType
Print
pubmed:volume
22
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
45-55
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed-meshheading:11233551-Aged, pubmed-meshheading:11233551-Coronary Circulation, pubmed-meshheading:11233551-Coronary Disease, pubmed-meshheading:11233551-Female, pubmed-meshheading:11233551-Heart, pubmed-meshheading:11233551-Humans, pubmed-meshheading:11233551-Image Processing, Computer-Assisted, pubmed-meshheading:11233551-Male, pubmed-meshheading:11233551-Middle Aged, pubmed-meshheading:11233551-Myocardial Infarction, pubmed-meshheading:11233551-Myocardial Stunning, pubmed-meshheading:11233551-Organophosphorus Compounds, pubmed-meshheading:11233551-Organotechnetium Compounds, pubmed-meshheading:11233551-Perfusion, pubmed-meshheading:11233551-Radiopharmaceuticals, pubmed-meshheading:11233551-Tomography, Emission-Computed, Single-Photon, pubmed-meshheading:11233551-Ventricular Function, Left
pubmed:year
2001
pubmed:articleTitle
The additive value of gated SPET myocardial perfusion imaging in patients with known and suspected coronary artery disease.
pubmed:affiliation
Department of Radiology, Leiden University Medical Center, The Netherlands. Croon@mail.medfac.leidenuniv.nl
pubmed:publicationType
Journal Article, Clinical Trial