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Serial Tomographic Imaging with Technetium-99m-Sestamibi for the Assessment of Infarct-Related Arterial Patency Following Reperfusion Therapy

Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota

Correspondence: For reprints contact: Raymond J. Gibbons, MD, Mayo Clinic, 200 First Street, S.W., Rochester, MN 55905.

ABSTRACT

The purpose of this study was to determine the relationship of changes in the seventy and extent of hypoperfusion on serial tomographic ^99mTc-sestamibi images with patency of the infarct related artery during acute myocardial infarction. We studied 109 patients with acute myocardial infarction using tomographic ^99mTc-sestamibi imaging acutely and at 18–48 hr later. Perfusion defect extent and defect area, an index of defect severity, were measured on both studies. Both defect extent and defect area were significantly (p = 0.0001) greater for anterior infarctions than for inferior and lateral infarctions. By two factor analysis of variance, the change in defect area varied significantly with both infarct location (p= 0.0001) and patency of the infarct-related artery (p = 0.002). The change in defect extent also varied significantly with both infarct location (p= 0.0001) and with patency of the infarct-related artery (p= 0.004). In patients with inferior myocardial infarction, a change in defect extent or defect area of greater than 4% or 0.017, respectively, had a positive predictive accuracy of 96% and 93%, respectively, for the identification of a patent infarct artery. Therefore, sequential changes on tomographic ^99mTc-sestamibi images are of potential value for the noninvasive assessment of patency of the infarct-related artery.

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				T. D. Miller, T. F. Christian, M. R. Hopfenspirger, D. O. Hodge, B. J. Gersh, and R. J. Gibbons Infarct Size After Acute Myocardial Infarction Measured by Quantitative Tomographic 99mTc Sestamibi Imaging Predicts Subsequent Mortality Circulation, August 1, 1995; 92(3): 334 - 341. [Abstract] [Full Text]