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Titolo:
Prediction of improvement of regional left ventricular function after revascularization using different perfusion-metabolism criteria
Autore:
Bax, JJ; Visser, FC; Elhendy, A; Poldermans, D; Cornel, JH; van Lingen, A; Boersma, E; Sloof, GW; Fioretti, PM; Visser, CA;
Indirizzi:
Leiden Univ Hosp, Dept Cardiol, NL-2333 AA Leiden, Netherlands Leiden UnivHosp Leiden Netherlands NL-2333 AA 33 AA Leiden, Netherlands Free Univ Amsterdam Hosp, Dept Cardiol, Amsterdam, Netherlands Free Univ Amsterdam Hosp Amsterdam Netherlands , Amsterdam, Netherlands Free Univ Amsterdam Hosp, Dept Nucl Med, Amsterdam, Netherlands Free Univ Amsterdam Hosp Amsterdam Netherlands , Amsterdam, Netherlands Erasmus Univ, Ctr Thorax, Dept Cardiol, NL-3000 DR Rotterdam, Netherlands Erasmus Univ Rotterdam Netherlands NL-3000 DR DR Rotterdam, Netherlands Erasmus Univ, Ctr Thorax, Dept Epidemiol, NL-3000 DR Rotterdam, Netherlands Erasmus Univ Rotterdam Netherlands NL-3000 DR DR Rotterdam, Netherlands Med Ctr, Alkmaar, Netherlands Med Ctr Alkmaar NetherlandsMed Ctr, Alkmaar, Netherlands Ist Cardiol, Udine, Italy Ist Cardiol Udine ItalyIst Cardiol, Udine, Italy
Titolo Testata:
JOURNAL OF NUCLEAR MEDICINE
fascicolo: 11, volume: 40, anno: 1999,
pagine: 1866 - 1873
SICI:
0161-5505(199911)40:11<1866:POIORL>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; POSITRON EMISSION TOMOGRAPHY; MYOCARDIAL CONTRAST ECHOCARDIOGRAPHY; REDISTRIBUTION TL-201 TOMOGRAPHY; F-18 FLUORODEOXYGLUCOSE; DOBUTAMINE ECHOCARDIOGRAPHY; HIBERNATING MYOCARDIUM; COMPUTED-TOMOGRAPHY; VIABLE MYOCARDIUM; BLOOD-FLOW;
Keywords:
F-18-fluorodeoxyglucose; SPECT; myocardial viability;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
40
Recensione:
Indirizzi per estratti:
Indirizzo: Bax, JJ Leiden Univ Hosp, Dept Cardiol, Rijsburgerweg 10, NL-2333 AA Leiden, Netherlands Leiden Univ Hosp Rijsburgerweg 10 Leiden Netherlands NL-2333 AA s
Citazione:
J.J. Bax et al., "Prediction of improvement of regional left ventricular function after revascularization using different perfusion-metabolism criteria", J NUCL MED, 40(11), 1999, pp. 1866-1873

Abstract

Increased myocardial uptake of F-18-fluorodeoxyglucose (FDG) in regions with perfusion defects (perfusion-FDG mismatch) has been shown to predict functional recovery after revascularization; conversely, a concordant decreasein perfusion and FDG uptake (perfusion-FDG match) represents scar tissue (varying from subendocardial to transmural scar) that will not improve in contractile function after revascularization. Several recent studies have used a mild reduction in perfusion or FDG uptake (or both) as an indicator of viable tissue. To our knowledge, this criterion has not been validated against functional outcome after revascularization. This study aimed to comparethe predictive value for functional recovery of these different perfusion-metabolism criteria. Methods: Forty-two patients referred for revascularization were studied with early resting Tl-201 SPECT (to evaluate perfusion) and FDG SPECT Contractile function was evaluated before and 3-4 mo after revascularization using two-dimensional echocardiography. Angiography was not repeated. Results: Two hundred six dysfunctional segments were identified; functional recovery occurred in 71 segments. The 206 dysfunctional segmentswere divided into five groups: group I, segments (n = 37) with normal perfusion; group II, segments (n = 69) with a mild reduction in perfusion (greater than or equal to 60% of normal Tl-201 uptake) without increased FDG uptake (mild match); group Iii, segments (n = 29) with a mild reduction in perfusion and increased FDG uptake (mild mismatch); group IV, segments (n = 46) with a more severe reduction in perfusion (<60% of normal Tl-201 uptake) without increased FDG uptake (severe match); and group V, segments (n = 25)with a Tl-201 activity < 60% and increased FDG uptake (severe mismatch). The mean wall motion score improved significantly in groups I, III and V butnot in groups II and IV. Improvement of function was observed in 76% of group I segments, in 69% of group III segments and in 68% of group V segments. In contrast, only 13% of group II segments and 7% of group IV segments improved after revascularization, Conclusion: The results indicate that normal perfusion and mismatch patterns (either mild or severe) are predictive offunctional recovery, whereas match patterns (either mild or severe) are predictive of absence of recovery. Match patterns are likely to represent different degrees of scar tissue, ranging from subendocardial to transmural scars. To identify segments with a high likelihood of improvement of functionafter revascularization, integration of information on perfusion and FDG uptake appears mandatory.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 15:04:33