Effect of left ventricular function on the assessment of myocardial viability by technectium-99m sestamibi and correlation with positron emission tomography in patients with healed myocardial infarcts or stable angina pectoris, or both

摘要: Abstract The accuracy of technetium-99m (Tc-99m) sestamibi single-photon emission computed tomography (SPECT) for the assessment myocardial viability in patients with coronary artery disease and left ventricular (LV) dysfunction is not defined completely. This study determines whether performance Tc-99m SPECT detection differs between mild-tomoderate disease. Patients regional and/or global LV were separated into 2 groups on basis ejection fraction (EF) at rest: group 1 (LVEF >25%, mean 36 ± 6%, n = 9), ≤25%, 17 5%, 11). All underwent semiquantitative positron (PET) rest N-13 ammonia F-18 fluorodeoxyglucose. overall concordance PET was 89% 78% (p 0.002). Discordance almost exclusively due to viable nonviable regions. In regions hypoperfusion by PET, only 64% 0.0015). reduced perfusion relatively increased metabolic activity (“flow: metabolism mismatch”), identified 88% as viable, but 42% Thus, while shows a good mild-to-moderate dysfunction, it may underestimate severe particularly those assessed PET.