Early prediction of regional functional recovery in reperfused myocardium using single-injection resting quantitative electrocardiographic gated SPET View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2002-02-16

AUTHORS

Hirohiko Kurihara, Seishi Nakamura, Kengo Hatada, Kazuya Takehana, Shinichi Hamada, Junko Watanabe, Reisuke Yuyama, Jun Mimura, Tetsuro Sugiura, Toshiji Iwasaka

ABSTRACT

. By evaluating concordant or discordant perfusion and systolic wall thickening patterns, resting quantitative electrocardiographic (ECG) gated single-photon emission tomography (SPET) can identify various myocardial pathological conditions with different functional recovery after revascularisation therapy. However, no data are available on the ability of this methodology to predict regional functional recovery after primary percutaneous transluminal coronary angioplasty (PTCA). This study evaluated whether single-injection ECG gated SPET imaging performed at rest with 99mTc-tetrofosmin early after successful PTCA can predict recovery of regional wall motion. ECG gated SPET was performed 3 days and 3 weeks after successful PTCA in 26 patients. Regional functional parameters were automatically calculated with a 20-segment model on the day 3 image, and segments with perfusion/thickening mismatch were defined as showing preserved perfusion (>55% uptake on the end-diastolic image: mean–standard deviation of the normal value) without systolic wall thickening (mean–standard deviation of the normal value). On the third day, the regional wall motion score of 37 mismatched segments (3.8±2.1) was significantly lower than that of 41 matched normal segments (6.0±2.9), but was significantly higher than that of 108 matched abnormal segments (1.4±1.9, both P<0.01). At 3 weeks after acute MI, the regional wall motion score of mismatched segments (6.4±3.9) improved to the level of matched normal segments (7.1±3.0) and was significantly higher than that of matched abnormal segments (2.5±3.0, P<0.01). Absolute change in the regional wall motion score (3 days to 3 weeks) of mismatched segments (2.6±3.5) was significantly greater than that in the regional wall motion score of matched normal segments and matched abnormal segments (1.1±1.3 and 1.2±2.6, respectively, both P<0.05). Twenty-seven of 37 segments (73%) with perfusion/thickening mismatch showed significant improvement in regional wall motion, whereas improvement in regional wall motion was observed in 22 of 108 segments (20%) with matched abnormal segments and 6 of 41 segments (15%) with matched normal segments. Segments with perfusion/thickening mismatch had a significantly higher incidence of regional functional improvement than did matched abnormal or matched normal segments (χ2=42.3, P<0.01). Thus, by estimating both perfusion and wall thickening, single-injection resting ECG gated SPET imaging with 99mTc-tetrofosmin early after primary PTCA can predict recovery of regional wall motion after successful reperfusion. More... »

PAGES

458-464

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00259-001-0725-x

DOI

http://dx.doi.org/10.1007/s00259-001-0725-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1026720902

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/11914882


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28 schema:description Abstract. By evaluating concordant or discordant perfusion and systolic wall thickening patterns, resting quantitative electrocardiographic (ECG) gated single-photon emission tomography (SPET) can identify various myocardial pathological conditions with different functional recovery after revascularisation therapy. However, no data are available on the ability of this methodology to predict regional functional recovery after primary percutaneous transluminal coronary angioplasty (PTCA). This study evaluated whether single-injection ECG gated SPET imaging performed at rest with 99mTc-tetrofosmin early after successful PTCA can predict recovery of regional wall motion. ECG gated SPET was performed 3 days and 3 weeks after successful PTCA in 26 patients. Regional functional parameters were automatically calculated with a 20-segment model on the day 3 image, and segments with perfusion/thickening mismatch were defined as showing preserved perfusion (>55% uptake on the end-diastolic image: mean–standard deviation of the normal value) without systolic wall thickening (mean–standard deviation of the normal value). On the third day, the regional wall motion score of 37 mismatched segments (3.8±2.1) was significantly lower than that of 41 matched normal segments (6.0±2.9), but was significantly higher than that of 108 matched abnormal segments (1.4±1.9, both P<0.01). At 3 weeks after acute MI, the regional wall motion score of mismatched segments (6.4±3.9) improved to the level of matched normal segments (7.1±3.0) and was significantly higher than that of matched abnormal segments (2.5±3.0, P<0.01). Absolute change in the regional wall motion score (3 days to 3 weeks) of mismatched segments (2.6±3.5) was significantly greater than that in the regional wall motion score of matched normal segments and matched abnormal segments (1.1±1.3 and 1.2±2.6, respectively, both P<0.05). Twenty-seven of 37 segments (73%) with perfusion/thickening mismatch showed significant improvement in regional wall motion, whereas improvement in regional wall motion was observed in 22 of 108 segments (20%) with matched abnormal segments and 6 of 41 segments (15%) with matched normal segments. Segments with perfusion/thickening mismatch had a significantly higher incidence of regional functional improvement than did matched abnormal or matched normal segments (χ2=42.3, P<0.01). Thus, by estimating both perfusion and wall thickening, single-injection resting ECG gated SPET imaging with 99mTc-tetrofosmin early after primary PTCA can predict recovery of regional wall motion after successful reperfusion.
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36 MI
37 ability
38 abnormal segments
39 absolute change
40 acute MI
41 angioplasty
42 changes
43 conditions
44 coronary angioplasty
45 data
46 day 3 image
47 days
48 different functional recovery
49 discordant perfusion
50 early prediction
51 electrocardiographic gated SPET
52 emission tomography
53 functional improvement
54 functional parameters
55 functional recovery
56 gated single-photon emission tomography
57 high incidence
58 images
59 improvement
60 incidence
61 levels
62 methodology
63 mismatch
64 mismatched segments
65 model
66 motion
67 motion score
68 myocardial pathological conditions
69 myocardium
70 normal segments
71 parameters
72 pathological conditions
73 patients
74 patterns
75 percutaneous transluminal coronary angioplasty
76 perfusion
77 perfusion/
78 perfusion/thickening mismatch
79 prediction
80 primary PTCA
81 primary percutaneous transluminal coronary angioplasty
82 quantitative electrocardiographic gated SPET
83 recovery
84 regional functional improvement
85 regional functional parameters
86 regional functional recovery
87 regional wall motion
88 regional wall motion score
89 reperfusion
90 rest
91 revascularisation therapy
92 scores
93 segments
94 significant improvement
95 single-injection ECG
96 single-photon emission tomography
97 study
98 successful primary percutaneous transluminal coronary angioplasty
99 successful reperfusion
100 systolic wall thickening
101 systolic wall thickening patterns
102 therapy
103 thickening
104 thickening mismatch
105 thickening patterns
106 third day
107 tomography
108 transluminal coronary angioplasty
109 wall motion
110 wall motion score
111 wall thickening
112 wall thickening patterns
113 weeks
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