Impact of revascularization and myocardial viability determined by nitrate-enhanced Tc-99m sestamibi and Tl-201 imaging on mortality and functional outcome in ischemic cardiomyopathy.

摘要: Nitrate-enhanced perfusion imaging has been shown to detect viability in dysfunctional myocardium, but nitrate-enhanced technetium 99m sestamibi not compared with thallium 201. Fifty-six patients ischemic cardiomyopathy and heart failure (New York Heart Association classes II-IV) were scheduled for revascularization. Through use of a matching 12-segment model, Tl-201 Tc-99m uptake at rest was assessed by 2 sets blinded investigators. All single photon emission computed tomography data read separately. Additional exercise performed on separate day. Myocardial thought be present when the tracer score less than 3 (normal, 0; absent, 4). Of 56 undergo revascularization, only 23 (41%) underwent procedure remainder continued medical therapy. Functional assessment echocardiography 21 ± 8 months, survival determined 40 18 months. The baseline clinical hemodynamic parameters similar revascularization (n = 23) therapy 33) groups. Perfusion scores segments. Stress reversible defects predicted significant improvement left ventricular function those without (P < .01) after Cox regression model showed that least 5 segments viable, produced greater improvements New class, better trend toward .07 P .06 Tc-99m), significantly impact reverse remodeling. myocardial are equivalent predicting functional improvements, remodeling, cardiomyopathy.