Myocardial washout rate of technetium-99m-sestamibi in the chronic phase predicts myocardial damage in patients with previous myocardial infarction

被引:1
作者
Ashikaga, Kohei [1 ]
Akashi, Yoshihiro J. [1 ]
Yoneyama, Kihei [1 ]
Kida, Keisuke [1 ]
Suzuki, Kengo [1 ]
Miyake, Fumihiko [1 ]
机构
[1] St Marianna Univ, Sch Med, Dept Internal Med, Div Cardiol,Miyamae Ku, Kawasaki, Kanagawa 2168511, Japan
关键词
Tc-99m-sestamibi; The washout rate; Myocardial infarction; The chronic phase; PERCUTANEOUS CORONARY INTERVENTION; CHRONIC HEART-FAILURE; TERM-FOLLOW-UP; NATRIURETIC PEPTIDE; TC-99M SESTAMIBI; REPERFUSION THERAPY; PROGNOSTIC VALUE; CREATINE-KINASE; TROPONIN-T; TC-99M-SESTAMIBI;
D O I
10.1007/s12149-011-0519-6
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
This study aimed to clarify the correlation between the myocardial washout rate (WR) of technetium-99m hexakis 2-methoxy-isobutyl-isonitrile (Tc-99m-sestamibi) and cardiac enzyme levels in patients with acute myocardial infarction (AMI) 6 months after the onset. Sixty-one consecutive AMI patients (mean age, 66.2 +/- A 9.7 years) who underwent percutaneous coronary intervention (PCI) on admission were enrolled. Creatinine kinase MB isoenzyme (CK-MB) levels were measured every 3 h. Tc-99m-sestamibi myocardial scintigraphic images were obtained at the early (30 min) and delayed (4 h) phases after tracer injection for calculating heart-to-mediastinum (H/M) ratios and global WRs at 2 weeks (0 M) and 6 months (6 M) after the onset of AMI. Regional WRs in the culprit lesions (culprit WR) and the extent score (ES) and severity score (SS) of myocardial damage were also calculated. PCI was performed 8.3 +/- A 7.7 h after AMI onset. At 6 M, the early H/M ratio (p = 0.04), delayed H/M ratio (p = 0.02), global WR (p = 0.01), culprit WR (p = 0.002), and delayed ES (p = 0.008) were alleviated. At 0 M, the peak CK-MB level correlated with the delayed H/M ratio (p = 0.003), global WR (p = 0.003), culprit WR (p < 0.001), early ES (p = 0.03), delayed ES (p = 0.01), early SS (p = 0.001), and delayed SS (p < 0.001). At 6 M, the peak CK-MB level correlated with the delayed H/M ratio (p < 0.001), global WR (p = 0.005), culprit WR (p = 0.001), early ES (p = 0.001), delayed ES (p < 0.001), early SS (p < 0.001), and delayed SS (p < 0.001). These results demonstrated that Tc-99m-sestamibi WR in the chronic phase as well as that in the acute phase reflects the extent of initial myocardial damage in AMI patients after PCI. Moreover, it might indicate the myocardial condition in the clinical course.
引用
收藏
页码:740 / 748
页数:9
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