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Titolo:
ASSESSMENT OF MYOCARDIAL VIABILITY BY DOBUTAMINE ECHOCARDIOGRAPHY, POSITRON-EMISSION-TOMOGRAPHY AND TL-201 SPECT - CORRELATION WITH HISTOPATHOLOGY IN EXPLANTED HEARTS
Autore:
BAUMGARTNER H; PORENTA G; LAU YK; WUTTE M; KLAAR U; MEHRABI M; SIEGEL RJ; CZERNIN J; LAUFER G; SOCHOR H; SCHELBERT H; FISHBEIN MC; MAURER G;
Indirizzi:
UNIV VIENNA,VIENNA GEN HOSP,DEPT CARDIOL,WAHRINGER GURTEL 18-20 A-1090 VIENNA AUSTRIA LUDWIG BOLTZMAN INST CARDIOVASC RES VIENNA AUSTRIA CEDARS SINAI MED CTR,DEPT CARDIOL LOS ANGELES CA 90048 CEDARS SINAI MED CTR,DEPT PATHOL LOS ANGELES CA 90048 UNIV CALIF LOS ANGELES,MED CTR,DEPT NUCL MED LOS ANGELES CA 90048
Titolo Testata:
Journal of the American College of Cardiology
fascicolo: 6, volume: 32, anno: 1998,
pagine: 1701 - 1708
SICI:
0735-1097(1998)32:6<1701:AOMVBD>2.0.ZU;2-C
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; LEFT-VENTRICULAR DYSFUNCTION; VIABLE MYOCARDIUM; ISCHEMIC CARDIOMYOPATHY; REDISTRIBUTION-REINJECTION; COMPUTED-TOMOGRAPHY; TL-201 TOMOGRAPHY; REVASCULARIZATION; RECOVERY; IDENTIFICATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
31
Recensione:
Indirizzi per estratti:
Citazione:
H. Baumgartner et al., "ASSESSMENT OF MYOCARDIAL VIABILITY BY DOBUTAMINE ECHOCARDIOGRAPHY, POSITRON-EMISSION-TOMOGRAPHY AND TL-201 SPECT - CORRELATION WITH HISTOPATHOLOGY IN EXPLANTED HEARTS", Journal of the American College of Cardiology, 32(6), 1998, pp. 1701-1708

Abstract

Objectives. We examined the relationship among viability assessment by dobutamine echocardiography (DE), positron emission tomography (PET)and thallium-201 single-photon emission computed tomography (TI-SPECT) to the degree of fibrosis. Background. DE, PET and TI-SPECT have been shown to be sensitive in identifying viability of asynergic myocardium. However, PET and TI-SPECT indicated viability in a significant percentage of segments without dobutamine response or functional improvement after revascularization. Methods. Twelve patients with coronary artery disease and severely reduced left ventricular function (EF 14.5 +/- 5.2%) were studied with DE prior to cardiac transplantation: 5 had additional PET and 7 had Tl-SPECT studies. Results of the three techniques were compared to histologic findings of the explanted hearts. Results. Segments with >75% viable myocytes by histology were determined to be viable in 78%, 89% and 87% by DE, PET and Tl-SPECT; those with 50-75% viable myocytes in 71%, 50% and 87%, respectively. Segments with25-50% viable myocytes showed response to dobutamine in only 15%, butwere viable in 60% by PET and 82% by Tl-SPECT. Segments with <25% viable myocytes responded to dobutamine in 19%; however, PET and TI-SPECTdemonstrated viability in 33% and 38%, respectively. Discrepant segments without dobutamine response but viability by PET and SPECT had significantly more viable myocytes by pathology than did those classifiedin agreement to be nonviable but had significantly less viable myocytes than those classified in agreement to be viable (p < .001). Conclusions. These findings suggest that contractile reserve as evidenced by a positive dobutrtmine response requires at least 50% viable myocytes in a given segment whereas scintigraphic methods also identify segments with less viable myocytes. Thus, the methods may provide complementary information: Nuclear techniques appear to be highly sensitive for the detection of myocardial viability, and negative tests make it highly unlikely that a significant number of viable myocytes are present ina given segment. Conversely, dobutamine echo may be particularly useful for predicting recovery of systolic function after revascularization. (J Am Cell Cardiol 1998;32:1701-8) (C) 1998 by the American Collegeof Cardiology.

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Documento generato il 07/04/20 alle ore 23:15:07