Fridon Todua MD, Abstract Co-Author: Nothing to Disclose

Tamar Vakhtangadze MD,PhD, Presenter: Nothing to Disclose

Michael Baramia PhD, Abstract Co-Author: Nothing to Disclose

The goal of this study is to determine the effectiveness of Nitroglycerine enhanced Tc99m Sestamibi Gated-SPECT investigation in the detection of viable tissue after myocardial infarct.

35 male patients (mean age 53,1 +/-7,69, range 37- 69yy) with confirmed myocardial infarction with mean EF was 38.7% +/- 5.8. All of the patients underwent myocardial perfusion studies using Tc-99 Sestamibi Gated SPECT acquisition at rest and after I/V infusion of Nitroglycerine. 21 patients with sufficient myocardium in infarcted area underwent revascularization procedures. Gated-SPECT acquisition was carried out on a single-head large field of view gamma camera (E-Cam Systems, Siemens).

The fixed perfusion defects were found in all cases confirming the diagnosis of previous myocardial infarct. Tracer uptake >30% in areas of fixed perfusion defects was found in 22 cases (62.9%). In 14 cases (40%) improvement was revealed, and in 3 cases (8.6%) worsening of perfusion after I/V infusion of Nitroglycerine. The improvement of tracer uptake had been developed in 5 cases with severely decreased tracer uptake in infarcted area. In 12 cases from 35 (34,3%) the decreased tracer uptake was found in areas at a distance from the scars, which could be considered as additional damage of myocardium. The iimprovement of contractility after revascularization was revealed in 16 patients (76.2%). Mean EF rose after surgery from 38.7% to 46.4%. There was a good correlation in the improvement of contractility in patients with increased tracer uptake after Nitroglicerin administration compared to tyhe rest studies. The patients with reduction of tracer uptake after nitroglicerin infusion also revealed the improvement of contractility.

Myocardial SPECT perfusion is important tool in assessment of viability in patients after myocardial infarct. Nitroglicerin enhanced images provides with the additional information regarding improvement of contractility and predicting outcomes of revasculariosation procedures. Patients with worsening of tracer uptake after Nitroglicerin infusion should undergo revascularisation procedures.

The goal of this study is to determine the effectiveness of Nitroglycerine enhanced Tc99m Sestamibi Gated-SPECT investigation in the detection of viable tissue after myocardial infarct.

35 male patients (mean age 53,1 +/-7,69, range 37- 69yy) with confirmed myocardial infarction with mean EF was 38.7% +/- 5.8. All of the patients underwent myocardial perfusion studies using Tc-99 Sestamibi Gated SPECT acquisition at rest and after I/V infusion of Nitroglycerine. 21 patients with sufficient myocardium in infarcted area underwent revascularization procedures. Gated-SPECT acquisition was carried out on a single-head large field of view gamma camera (E-Cam Systems, Siemens).

The fixed perfusion defects were found in all cases confirming the diagnosis of previous myocardial infarct. Tracer uptake >30% in areas of fixed perfusion defects was found in 22 cases (62.9%). In 14 cases (40%) improvement was revealed, and in 3 cases (8.6%) worsening of perfusion after I/V infusion of Nitroglycerine. The improvement of tracer uptake had been developed in 5 cases with severely decreased tracer uptake in infarcted area. In 12 cases from 35 (34,3%) the decreased tracer uptake was found in areas at a distance from the scars, which could be considered as additional damage of myocardium. The iimprovement of contractility after revascularization was revealed in 16 patients (76.2%). Mean EF rose after surgery from 38.7% to 46.4%. There was a good correlation in the improvement of contractility in patients with increased tracer uptake after Nitroglicerin administration compared to tyhe rest studies. The patients with reduction of tracer uptake after nitroglicerin infusion also revealed the improvement of contractility.

Myocardial SPECT perfusion is important tool in assessment of viability in patients after myocardial infarct. Nitroglicerin enhanced images provides with the additional information regarding improvement of contractility and predicting outcomes of revasculariosation procedures. Patients with worsening of tracer uptake after Nitroglicerin infusion should undergo revascularisation procedures.

Todua, F, Vakhtangadze, T, Baramia, M, Nitroglycerine-enhanced Tc99m Sestamibi-gated SPECT in Assessment of Viability after Myocardial Infarct.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4416202.html