ABSTRACT
Objective • To study the differences and correlations of quantitative analysis between Cedars-Sinai quantitative gated SPECT (QGS) and Emory cardiac toolbox (ECTb) used in single photon emission computed tomography (SPECT) gated myocardial perfusion imaging (G-MPI). Methods • A total of 28 patients were examined with 99mTc-methoxyisobutylisonitrile (99mTc-MIBI) SPECT G-MPI. The left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), end-systolic volume (ESV), phase histogram bandwidth (PHB) and phase standard deviation (PSD) were calculated with QGS and ECTb. The correlations and differences of the results from these two programs were analyzed. Results • These two software programs showed high correlation for LVEF, EDV and ESV (LVEF: r=0.917, P=0.000. EDV: r=0.976, P=0.000. ESV: r=0.981, P=0.000). The analysis showed no significant correlation for PHB and PSD (PHB: r=0.319, P=0.055. PSD: r=0.172, P=0.310). In the analysis of cardiac function, the ESV measured by QGS was higher than that measured by ECTb, and the EDV and LVEF were lower than those measured by ECTb. In the phase analysis, the PSD and PHB measured by QGS were lower than those measured by ECTb. These differences between the results measured by the two software programs were not consistency. There were significant differences in LVEF, ESV and PSD in the comparison of QGS and ECTb [LVEF: (47.8±16.9)% vs (57.4±17.2)%, P=0.000. ESV: (67.5±51.0) mL vs (58.3±50.0) mL, P=0.000. PSD: 20.5º±10.3º vs 30.6º±18.9º, P =0.004]. The EDV and PHB showed no significant difference between the QGS and ECTb [EDV: (116.8±52.8) mL vs (120.8±55.7) mL, P=0.050. PHB: 72.2º±37.0º vs 86.1º±55.7º, P=0.139]. Conclusion • These two software programs have good consistency in quantitative analysis of cardiac function. But the result shows no significant consistent in the evaluation of left ventricular mechanical dyssynchrony. There are differences between the data measured by QGS and ECTb. Using the results measured by the two software programs for direct comparison may be not suitable in clinical applications. The differences between these two software programs indicate that it may be necessary to establish a normal databases in clinical work based on the local conditions.
ABSTRACT
Objective: To explore the clinical value of adenosine triphosphate (ATP) stress99mTc-methoxyisobutylisonitrile (99mTc-MIBI) gated myocardial perfusion imaging (G-MPI) for evaluating the severity and region of myocardial ischemia and left ventricular function in patients with myocardial bridge. Methods: A total of 58 patients with CAG or CTA confirmed diagnosis of myocardial bridge received ATP stress99mTc-MIBI G-MPI examination in our hospital. The short and vertical long-axis image of left ventricular myocardium were divided into 13 segments and the radionuclide distribution was semi-quantitatively evaluated into 4 classes by 0-3 scores visually (0: normal, 1: mild reduction, 2: moderate reduction, 3: severe reduction). The summed stress score (SSS) of left ventricular myocardium was calculated, the severity and region of myocardial ischemia were judged and compared with the severity of myocardial bridge. The LVEF obtained by ATP stress 99mTc-MIBI G-MPI was compared with LVEF obtained by cardiac color ultrasound (UCG).Results: The detection rate of myocardial ischemia by ATP Stress 99mTc-MIBI G-MPI and by 24h dynamic ECGwere 82.76% vs 56.10%, P 0.05 and they had positive correlation (r =0.555, P <0.05).Conclusion: ATP stress 99mTc-MIBI G-MPI could accurately and intuitively evaluate the severity and region ofmyocardial ischemia and left ventricular function in patients with myocardial bridge, it has certain guiding value inclinical practice.
ABSTRACT
Objective: To determine the long-term prognostic value of ~(99m)Tc-sestamibi (MIBI) Gated myocardial perfusion imaging(G-MPI)in patients with coronary artery disease.Methods: A total of 1345 consecutive symptomatic coronary artery disease patients who underwent ~(99m)Tc-MIBI G-MPI were studied.1250 patients were followed-up by telephone interview, the median follow-up time was 26.7±13.6 months.Events were defined as cardiac death, nonfatal myocardial infarction and revascularization by coronary artery bypass graft or percutaneous coronary artery intervention.Results: Cox regression analysis indicated that summed stress score (3.8±6.1,χ~2=67.25), summed different score (1.1±3.0,χ~2=21.09) and left ventricular ejection fraction (LVEF) (0.667±0.097,χ~2=42.26) were independent predictive factors of cardiac events (P<0.01).Kaplan-Meier analysis indicated that cardiac event free survival was significantly lower in the patient with LVEF≤50%.Conclusion: In Patients with symptomatic coronary artery disease, the summed stress score, summed rest score, summed different score and LVEF had prognostic value, and low LVEF indicated worse prognosis.
ABSTRACT
Objective To evaluate the changes of cardiac function and myocardial perfusion by Gated 99Tcm-MIBI myocardial perfusion imaging after autologous mesenchymal stem cell implantation in patients with acute myocardial infarction at high altitude area.Methods 33 patients with anteroseptal myocardial infarction were ran- domly divided into two groups.18 patients (control group) underwent percutaneous tranluminal coronary angioplasty (PTCA) and 14 cases (transplantation group) received additional mesenchymal stem cell transplantation.Myocardi- al perfusion imaging were performed in all patients before and at 6 and 12 months after treatment.Results Com- pared to pre-implantation,LVEF of transplantation group was improved 8%～9%after 6 months.The improving lev- els of control group were lower.However,there were not statistical differences among all data.Conclusion Mesen- chymal stem cell transplantation could improve myocardial systolic function and myocardial perfusion.