Tl-201 SPECT for the detection of viable hybernating myocardium in chronic coronary occlusion
TI-201 SPECT za detekcijo viabilnega hiberniranega miokarda pri kronični zapori koronarnih arterij

english

1997

volume 31, issue 4

Onkološki inštitut Ljubljana

Twelve patients with 17 chronic occlusions over the last 1-4 months were examined with the SPECT Tl-201 myocardial perfusion scintigraphy and angiography before and 2 months after the PTCA (CABC), for the assessment of the improvement of the perfusion andkinetics. This improvement served as a reference method for the positive and negative predictive value of the SPECT study for the detection of viable hybernating myocardium. There were 52 segments (67%) with wevere reduced uptake of Thallium from the infarcted area and 44 (56%) were viable. On the basis of angiography the kinetics of 55 semgents was assessed. Of the segments with mild wall motion abnormalities (WMA) (19/55), 95% (18/19) were viable. Of the segments with severe WMA (36/55), 14/36 (39%) were viable. A good correlationbetween the severity of perfusion defects and WMA was demonstrated. The positive and negative predictive values of the SPECT-study were 87% and 84%. No influence of the duration of occlusion was proved. The presence of angiographycally detected collateral circulation was related to the higher percentage of viable segments. The kinetic improvement after PTCA was detected in 34 segments (16 of those with mild WMA - 84%, and 16 of those with severe WMA - 45%). Functional improvement was detected in 8 patients. The left ventricular ejection fraction increase was 5.6% + 5.6%. It was greater in the group with left ventiruclar dysfunction (7.6%4.8% versus 1.75%1.08%, p<0.01).

10.11.2023