Comparison between changes of R-Waves on electrocardiogram and myocardial SPECT images in patients with acute anterior myocardial infarction

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Abstracts Wednesday morning, April 21, 1999

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PREVALENCE OF TL-20t REVERSE REDISTRIBUTION IN DIABETIC PATIENTS, A, Antonopoulos, S, Arvanitakis, Th, Markouiis, Ph, Santos, E,Georgiou, M. Kyriakidis, Ch. Proukakis. Dept. of Medical Physics, University of Athens and Cardiology Branch of Ygeias Melathron Clinic, Athens, Greece Purpose: Previous studies have reported that the presence of reverse redistribution pattern (RR) has been associated with both acute myocardial infarction(AMI) and chronic coronary artery disease (CAD), Since diabetes mellitus (DM) was an important coexisting disease for many of the above pts, the hypothesis was tested whether RR was correlated with the presence of DM. Patients and Methods: We analysed retrospectively 143 coronary pts (mean age 58_+.]2years) who were referred to the Nuclear Laboratory for evaluation of their coronary disease status and 27 pts who were referred for evaluation of chest pain, There were 37 diabetic pts out of 170 (22%) (M/F:29/8), of whom 19 pts had CAD (group 1), while 18 had chest pain (group2). A semiquantltative scoring system was used for grading using a 4-point scale (O=normal to 3=absent uptake), Results: In total 592 myocardial segments were analysed of which 59 segments were hypoperfused after stress while 31 segments showed reverse redistribution and five exhibited fixed defects, Between the RR segments there were 12 with homogeneous distribution after stress, The mean number of segments showing underperfusion was greater after stress than at rest (1.58+O.76 vs O.97_+O,41, p
~mTc-MIBI MYOCARDIAL PERFUSION

SPECT IMAGING IN DETECTING CORONARY ARTERY DISEASE IN PATIENTS WITH VALVULAR DISEASE BEFORE OPERATION

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PERIPHERAL ARTERIAL TONOMETRY: COMPARISON WITH STRESS TL-201 SPECT IMAGING FOR DETECTING MYOCARDIAL ISCHEMIA P. Chouraqui, *A. Arditti, S. Livschitz, *A. Caspi, **J. Sheffy, **R P. Schnall, D A. Goor. Sheba Medical Center, *Kaplan Medical Center, and **Itamar Medical, Israel Background: Primary myocardial isehemia induced by balloon inflation during percutaneous coronary angioplasty is immediately followed by a rise in systemic vascular resistance (SVR) (Circulation 74:780, 1986). It is assumed that the arising SVR is associated with peripheral arterial constriction. Aims: A novel method o f continuous peripheral arterial tonometry (PAT) using a special finger plethysmograph, which continuously provides data about the peripheral intraarterial volumes changes, was evaluated. Methods: The efficiency of PAT in detecting myocardial ischemia was compared during exercise/redistribution T1-201 SPECT imaging. The study was performed in parallel in two medical centers and included a total of 194 patients (163 males). Results: Exact agreement between the two methods for myocardial ischemia was 85%. PAT had a sensitivity of 94%, specificity of 74% in detecting myocardial iischemia, and negative predictive value of 92%. Thus, compared to SPECT, PAT is a simple and accurate method for detecting myocardial ischemia. Currently its high negative predicted value may make it suitable for screening purposes.

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Journal of Nuclear Cardiology January/February 1999, Part 2

RF Shi, XJ Liu, W Fang, Cardiovascular Institute & Fu Wai Hospital, Chinese Academy of Medical Science, Beijing, RR.China The aim of this study was to detect coronary artery disease using 99~Tc-MIBI myocardial perfusion imaging in patients with valvular disease. Thirty patients with valvular disease confirmed by echocardiography underwent 99mTc-MIBImyocardial perfusion imaging using multiSPECT 1 hour after stress test (exercise, dipyridamole or dobutamine test) and were performed coronary angiography within 1 month before valvular operation. For 29 out of the 30 patients, the results of 99mTc-M1BI myocardial perfusion imaging were similar with those of coronary angiography, the concordance rate was 96.7% and the negative predictability was 100%. 99~Tc-MIBI myocardial perfusion imaging is a reliable non-invasive method for detecting coronary artery disease in patients with valvular disease and so as to draw up suitable operation programs for them.

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43.1 COMPARISON BETWEEN CHANGES OF R-WAVES ON ELCI'ROCARDIOGRAM AND MYOCARDIAL SPECT IMAGES IN PATIENTS WITH ACUTE ANTERIOR MYOCARDIAL INFARCTION M.OKADA, S.ISOBE, Y.TANAHASHI, Y.SAKA NAGOYA EKISAIKAI HOSPITAL, NAGOYA, JAPAN The purpose of the present study was to compare between the changes of R-waves on elecrocardiogram and myocardial SPECT images in the patients with acute anterior myocardial infarction (AMI). The study population consisted of 35 patients. The R-waves of precordial electrocardiogram were measured at one and four weeks after onset of AMI. The percent changes of R-waves[( 5", R4w-- 2 R l w ) / ( 5", Rlw) x100%] were calculated. The exercise TI-201 and 1-123 BMIPP myocardial SPECT significantly images were obtained and calculated "uptake rate" from circumferential profile analysis. The defect area was computed from the lower uptake rate of normal subjects. The discordant (TI<0.05). It was concluded that TI-201 and 1-123 BMIPP myocardial SPECT images were usefulness to evaluate the improvement of the R-waves on electrocardiogram in the acute anterior myocardial infarction.