著者

Toyama Takuji Hoshizaki Hiroshi Isobe Naoki Adachi Hitoshi Naito Shigeto Oshima Shigeru Taniguchi Koichi

出版者

社団法人日本循環器学会

雑誌

Japanese circulation journal (ISSN:00471828)

巻号頁・発行日

vol.64, no.12, pp.937-942, 2000-11-20

被引用文献数

6 6

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To identify and quantify the amount of viable hibernating myocardium in patients with chronic coronary artery disease, resting ^<201>Tl single photon emission computed tomography(SPECT) was compared with ^<99m>Tc-methoxy-isobutyl isonitrile(MIBI) SPECT after nitrate infusion (nitrate-^<99m>Tc-MIBI) and ^<201>Tl SPECT after ^<201>Tl with glucose-insulin-potassium infusion (^<201>Tl-GIK) in 25 patients. Twenty-one patients also underwent completely left ventriculography beforehand and 5±4 months afterwards. SPECT images were divided into 9 segments and scored visually from 0 (normal uptake) to 3 (absent). The defect score was calculated as the summation of the total scores(TDS) in each patient. The TDS of nitrate-^<99m>Tc-MIBI images (6.3±4.3) and ^<201>Tl-GIK images (5.8±4.2) were significantly lower than the 7.4±4.3 of resting ^<201>Tl images (p<0.01). Based on the improvement of wall motion after coronary revascularization, the sensitivity of ^<201>Tl-GIK imaging (85%) was significantly higher (p<0.05), and that of nitrate-^<99m>Tc-MIBI imaging (79%) also tended to be higher (p=0.08), than that of ^<201>Tl imaging (62%) in detecting viable myocardium. The specificity of the 3 methods was almost the same. The nitrate-^<99m>Tc-MIBI and ^<201>Tl-GIK methods were more useful than the resting ^<201>Tl method for evaluating viable hibernating myocardium. Furthermore, the ^<201>Tl-GIK method may provide a more accurate estimate of the amount of viable myocardium than the nitrate-^<99m>Tc-MIBI method.