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Titolo:
EVALUATION BY QUANTITATIVE 99M-TECHNETIUM MIBI SPECT AND ECHOCARDIOGRAPHY OF MYOCARDIAL PERFUSION AND WALL-MOTION ABNORMALITIES IN PATIENTSWITH DOBUTAMINE-INDUCED ST-SEGMENT ELEVATION
Autore:
ELHENDY A; GELEIJNSE ML; ROELANDT JRTC; VANDOMBURG RT; CORNELL JH; TENCATE FJ; POSTMATJOA J; REIJS AEM; ELSAID GM; FIORETTI PM;
Indirizzi:
UNIV HOSP ROTTERDAM DIJKZIGHT,THORAXCTR,BA 300,DR MOLEWATERPLEIN 40 3015 GD ROTTERDAM NETHERLANDS UNIV HOSP ROTTERDAM DIJKZIGHT,THORAXCTR 3015 GD ROTTERDAM NETHERLANDS UNIV HOSP ROTTERDAM DIJKZIGHT,DEPT NUCL MED 3015 GD ROTTERDAM NETHERLANDS ERASMUS UNIV ROTTERDAM ROTTERDAM NETHERLANDS
Titolo Testata:
The American journal of cardiology
fascicolo: 7, volume: 76, anno: 1995,
pagine: 441 - 448
SICI:
0002-9149(1995)76:7<441:EBQ9MS>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; EMISSION COMPUTED-TOMOGRAPHY; STRESS ECHOCARDIOGRAPHY; INFARCTION; LESIONS; ANGINA;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
26
Recensione:
Indirizzi per estratti:
Citazione:
A. Elhendy et al., "EVALUATION BY QUANTITATIVE 99M-TECHNETIUM MIBI SPECT AND ECHOCARDIOGRAPHY OF MYOCARDIAL PERFUSION AND WALL-MOTION ABNORMALITIES IN PATIENTSWITH DOBUTAMINE-INDUCED ST-SEGMENT ELEVATION", The American journal of cardiology, 76(7), 1995, pp. 441-448

Abstract

ST-segment elevation during exercise testing has been attributed to myocardial ischemia and wall motion abnormalities (WMA). However, the functional significance of ST-segment elevation during dobutamine stress testing (DST) has not been evaluated in patients referred for diagnostic evaluation of myocardial ischemia. DST (up to 40 mu g/kg/min) with simultaneous echocardiography and technetium-99m sestamibi single-photon emission computed tomography (SPECT) was performed in 229 consecutive patients with suspected myocardial ischemia who were unable to perform an adequate exercise test; 127 (55%) had a previous acute myocardial infarction (AMI). ST elevation was defined as greater than or equal to 1 mm new or additional J point elevations with a horizontal or upsloping ST segment lasting 80 ms. Reversible perfusion defects on SPECT and new or worsening WMA during stress on echocardiography were considered diagnostic of ischemia. ST elevation occurred in 40 patients (17%) during the test; 34 of them (85%) had previous AMI. All patients with ST-segment elevation had abnormal scintigrams (fixed or reversible defects, or both) and abnormal wall motion (fixed or transient defects, or both) at peak stress. In patients who had ST elevation and no previous AMI (n = 6), ischemia was detected in all by echocardiography and in 5 (83%) by SPECT. In patients with previous AMI, the prevalenceof ischemia was not different with or without ST elevation (53% vs 43% by echocardiography and 53% vs 48% by SPECT, respectively). Baselineregional wall motion score in the infarct zone was higher in patientswith ST elevation. In conclusion, myocardial perfusion defects and WMA at peak stress are a hallmark in patients with ST-segment elevation during DST. However, ST-segment elevation is a specific marker of ischemia only in patients without previous AMI.

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Documento generato il 21/01/20 alle ore 01:33:05