Your browser doesn't support javascript.
loading
Comparative study between low dose dobutamine echocardiography and low dose dobutamine gated single photon emission computed tomography [gSPECT] in detection of myocardial viability
Suez Canal University Medical Journal. 2004; 7 (1): 79-90
in English | IMEMR | ID: emr-69041
ABSTRACT
The identification of severely dysfunctional but viable myocardium is of particular importance for the selection of patients with depressed left ventricular function who will benefit from coronary revascularization. Assessment of inotropic reserve with dobutamine has recently been used for this purpose. Comparing the accuracy of low-dose dobutamine [LDD] gated myocardial SPECT [gSPECT] with the accuracy of low dose dobutamine echocardiography [DSE] and resting perfusion single photon emission computed tomogra phytomography [SPECT] for the identification of viable myocardium in patients with previous myocardial infarction. Resting and low-dose dobutamine [7.5 micro g/kg/min] gated 99mTc-tetrofosmin gSPECT [TI and T2 respectively] and echocardiography [at rest and during low dose dobutamine] [R and DSE] and resting post-revascularization echocardiography [PRecho] [3 months later] were prospectively studied in 33 patients with previous myocardial infarction and severely depressed regional [function. Revascularization had been done either by CABG or PTCA for all patients. Nitroglycarine had been administered 15 min for all patients before 99m Tc-tetroforminT2. Wall motion assessment was done using 4 point score with 1 normal and 4 dyskinetic and viable tissue was diagnosed by presence of contractile response [CD] during LDD infusion in hoth echocardiography and gated SPECT using 17 segment model. Viability was defined in perfusion study by a relative Uptake 50% of tile maximum uptake. Viability in "SPECT depended upon both end-diastolic [ED] image [perfusion] and End-systolic [ES] [Contractility] images. Out of the 561 myocardial segments resting echo [R] revealed 367 segments with normal wall motion [NWM], 109 hypokinetic with CD in 83, 52 akinetic with CD in 24, 33 dyskinetic with CD in 3. Post-revascularization echo revealed 476 segments with NWM, 26 hypo, 29 ak., and 30 dyskinetic. Concerning gSPECT, out of the 194 segments with abnormal wall motion. T1 and T2 revealed 16 and 23 with normal uptake, 11 and 18 with complete reversibility, 60 and 96 with partial reversibility with overall detection of viability in 44.8% and 70.% respectively. Degree of matching between DSE and T1 and T2 was found to be 70.6% and 80.9% respectively. Compared to PR echo., degree of matching was 69.6%, 92.3% and 85.6% for TI, T2 and DSE respectively. Pharmacological enhancement for detecting viability either by gSPECT or echocardiography. Combined Perfusion and functional assessment compensates for lower sensitivity of [99m]Tc-tetrofosmin
Subject(s)
Search on Google
Index: IMEMR (Eastern Mediterranean) Main subject: Tomography, Emission-Computed, Single-Photon / Risk Factors / Coronary Angiography / Echocardiography, Stress / Diabetes Mellitus / Dobutamine / Hemodynamics / Hyperlipidemias / Hypertension Limits: Female / Humans / Male Language: English Journal: Suez Canal Univ. Med. J. Year: 2004

Similar

MEDLINE

...
LILACS

LIS

Search on Google
Index: IMEMR (Eastern Mediterranean) Main subject: Tomography, Emission-Computed, Single-Photon / Risk Factors / Coronary Angiography / Echocardiography, Stress / Diabetes Mellitus / Dobutamine / Hemodynamics / Hyperlipidemias / Hypertension Limits: Female / Humans / Male Language: English Journal: Suez Canal Univ. Med. J. Year: 2004