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Effects of nitroglycerin on myocardial defect size in acute myocardial infarction
$30
Abstracts
JOURNAL OF NUCLEAR CARDIOLOGY
Monday afternoon, April 24, 1995
M O N D A Y P M A P R I L
March/April 1995, Part 2
P05-117
P05-119
OPTIMIZATION OF 1-123 IPPA MYOCARDIAL SPECT IMAGES: WHAT IS THE RIGHT FILTER?
t~,sCI'S OF N I T N O G L ~
ZX He, G Guidry, JJ Mahmarian, R Taillefer, A Iskandrian, G. Heller, MS Verani for the IPPA Multicenter Trial. Baylor College of Medicine, Houston, TX, USA
G Zuin, M Sicolo, F Di Pede, G Turisno, P Pucci, G Bisi, PF Fazzini, E Piccolo. Divisicn of Cardiology aqd Nuclear Medicine Service of Meslre-Venice and Florence - Italy.
1-123 iodophenyl pentadecanoic acid (IPPA) has been recently used for evaluation of myocardial metabolism This study assessed which filters are optimal for IPPA SPECT. Myocardial SPECT was performed at rest on 15 pts with coronary artery disease, 4' and 30' following intravenous administration of IPPA (4-5 rnCi). On a first step, SPECT images reconstructed with Hamming, Parzen, Ramp, Gaussian and Butterworth filters were compared for quality of myocardial and cavity delineation, ease of defect identification and separation from adjacent structures The best filter (Butterworth) was then selected for further analysis using combinations of cutoff frequencie s (035, 045, 055 Nyquist) and orders (5, 10). The reconstructed images were then displayed simultaneously and evaluated by consensus of two experts. Best images were obtained with a CF=0.45 and order=10. Thus, optimization of IPPA myocardial SPECT, which is critical for enhancing image analysis, can be achieved using widely available filters.
(m~)
ON MYOCAF~IAL DEFECT SIZE IN AO3PE MYOCARDIAL IAFAFLTION.
The
effects of lOmg/24h iransdermal nitroglycerin after acute ~
( ~ m m t R) ~ m s ~
i n f a r c t i c ~ , an l e f t v e n t r i c u l a r defect s i z e , was assessed i n 65 p t s who underwent 99mTo-MIBI (44 pt s ) or 201T1 (21 pt s ) myocardial s c i n t ~ a t r e s t and a f t e r bi c yc l e exercise (30W/~n') at 2 weeks snd at 6 mondos. P l a n m images were acquired mad scored visually (O=normoperOasicn, l=mild asd 2=moderate kg/poperfusion, ~-absence of
perfusien). Results: (mean values of total score are reported) NID (31 pto) Placebo (34 pts) rest stress rest stress 2 we~gs I0,3 12,2 8.3 10.8 6 months 8,7 10.9 7.4 9.1 % - i~ - 11% - 11% - 16~ Ccnclusians: NTG gre~o s&ows s greater decrease of rest total score (2 weeks vs 6 mcnths) and a lesse~ decrease of stress total score; this ms~ be due to a favorable effect of NIG on the viable myecardium recovery.
P05-118
P05-120
DETECTION OF SEPTAL ISCHEMIA ~ I T H IODINE 123PHENYLPENTADECANOIC ACID (p-IPPA) IN PATIENTS WITH LEFT BUNDLE BRANCH BLOCK.
Tc99m-TETROFOSMIN FOR DIPYRIDAMOLE STRESS MYOCARDIAL SPECT. INTRA-INDIVIDUAL COMPARISON WITH TC99m-SESTAMIBL P. Flamen, M. Rosseel, H. Everaert, A. Bossuyt, P.R. Franken. Department of Nuclear Medicine, University Hospital, Free University of Brussels (AZ VUB),Brussels, Belgium.
R.G.E.J.Groutars. J,F.Verzijlbergen, C.A.P.L. Aseoop. St.Antonius Hospital, Nieuwegein, the Netherlands, In this study, we tested the hypothesis that in symptomatic patients with a left bundle branch block(LBBB) exercise induced septal myocardial ischemia occurs independent of coronary artery disease(CAD),due to asynchronic septal contraction. Regional myocardial ischemia can be detected with delayed clearance of p-IPPA, We examined 13 patients with and 6 without LBBB by p-IPPA exercise scintigraphy and coronary arteriography, There was no CAD. Dynamic images (I frame/minute) were acquired in a 40~ projection during 60 minutes. The mean apicalseptal p-IPPA washout rate in patients with LBBB during the first 20 minutes was 2 • 3% compared with 11 • 3% in the apical-lateral segment (p
The aim of this work was to determine whether tetrofosmin could be more suitable than sestamibi for pharmacological stress testing in a one-day protocol. Methods: Thirty patients underwent two similar one-day, rest and dipyridamole stress imaging protocols, one using tetrofosmin, the other using sestamibi. SPECT was performed 60 minutes after tracer administration. Images were analyzed both visually and quantitatively. Results: Heart-to-liver activity ratios were higher for tetrofosmin than for sestamibi, both in the resting (1.19i-0.39 vs 0.96!4).45; I><0.05) as in the stress studies (1.37:t:0.37 vs 1.055:0.42; p<0.05). Heart-to-lung ratios were similar for both tracers. In segments showing abnormal uptake during stress, the perfusion indexes were similar with tetrofosmin and sestamibi, as well at rest (66.8%+17.2 vs 66.7%:1:16.4) as at stress (60.5%5:15.7 vs 59.7%+16.6). The degree of'reversibility of these segments was also similar for both tracers (6.3%+7.7 vs 6.9%:~-9.3). The extent, intensity and severity of the perfusion defects were similar in both tracer studies, Conclusions: Our study results indicate that tetrofosmin offers a more optimal biodistribution than sestamibi when used in a one-day, rest and dipyridamole stress imaging setting. However, no difference in quality nor in the diagnostic interpretation of the images could be demonstrated.
Abstracts
JOURNAL OF NUCLEAR CARDIOLOGY
Monday afternoon, April 24, 1995
M O N D A Y P M A P R I L
March/April 1995, Part 2
P05-117
P05-119
OPTIMIZATION OF 1-123 IPPA MYOCARDIAL SPECT IMAGES: WHAT IS THE RIGHT FILTER?
t~,sCI'S OF N I T N O G L ~
ZX He, G Guidry, JJ Mahmarian, R Taillefer, A Iskandrian, G. Heller, MS Verani for the IPPA Multicenter Trial. Baylor College of Medicine, Houston, TX, USA
G Zuin, M Sicolo, F Di Pede, G Turisno, P Pucci, G Bisi, PF Fazzini, E Piccolo. Divisicn of Cardiology aqd Nuclear Medicine Service of Meslre-Venice and Florence - Italy.
1-123 iodophenyl pentadecanoic acid (IPPA) has been recently used for evaluation of myocardial metabolism This study assessed which filters are optimal for IPPA SPECT. Myocardial SPECT was performed at rest on 15 pts with coronary artery disease, 4' and 30' following intravenous administration of IPPA (4-5 rnCi). On a first step, SPECT images reconstructed with Hamming, Parzen, Ramp, Gaussian and Butterworth filters were compared for quality of myocardial and cavity delineation, ease of defect identification and separation from adjacent structures The best filter (Butterworth) was then selected for further analysis using combinations of cutoff frequencie s (035, 045, 055 Nyquist) and orders (5, 10). The reconstructed images were then displayed simultaneously and evaluated by consensus of two experts. Best images were obtained with a CF=0.45 and order=10. Thus, optimization of IPPA myocardial SPECT, which is critical for enhancing image analysis, can be achieved using widely available filters.
(m~)
ON MYOCAF~IAL DEFECT SIZE IN AO3PE MYOCARDIAL IAFAFLTION.
The
effects of lOmg/24h iransdermal nitroglycerin after acute ~
( ~ m m t R) ~ m s ~
i n f a r c t i c ~ , an l e f t v e n t r i c u l a r defect s i z e , was assessed i n 65 p t s who underwent 99mTo-MIBI (44 pt s ) or 201T1 (21 pt s ) myocardial s c i n t ~ a t r e s t and a f t e r bi c yc l e exercise (30W/~n') at 2 weeks snd at 6 mondos. P l a n m images were acquired mad scored visually (O=normoperOasicn, l=mild asd 2=moderate kg/poperfusion, ~-absence of
perfusien). Results: (mean values of total score are reported) NID (31 pto) Placebo (34 pts) rest stress rest stress 2 we~gs I0,3 12,2 8.3 10.8 6 months 8,7 10.9 7.4 9.1 % - i~ - 11% - 11% - 16~ Ccnclusians: NTG gre~o s&ows s greater decrease of rest total score (2 weeks vs 6 mcnths) and a lesse~ decrease of stress total score; this ms~ be due to a favorable effect of NIG on the viable myecardium recovery.
P05-118
P05-120
DETECTION OF SEPTAL ISCHEMIA ~ I T H IODINE 123PHENYLPENTADECANOIC ACID (p-IPPA) IN PATIENTS WITH LEFT BUNDLE BRANCH BLOCK.
Tc99m-TETROFOSMIN FOR DIPYRIDAMOLE STRESS MYOCARDIAL SPECT. INTRA-INDIVIDUAL COMPARISON WITH TC99m-SESTAMIBL P. Flamen, M. Rosseel, H. Everaert, A. Bossuyt, P.R. Franken. Department of Nuclear Medicine, University Hospital, Free University of Brussels (AZ VUB),Brussels, Belgium.
R.G.E.J.Groutars. J,F.Verzijlbergen, C.A.P.L. Aseoop. St.Antonius Hospital, Nieuwegein, the Netherlands, In this study, we tested the hypothesis that in symptomatic patients with a left bundle branch block(LBBB) exercise induced septal myocardial ischemia occurs independent of coronary artery disease(CAD),due to asynchronic septal contraction. Regional myocardial ischemia can be detected with delayed clearance of p-IPPA, We examined 13 patients with and 6 without LBBB by p-IPPA exercise scintigraphy and coronary arteriography, There was no CAD. Dynamic images (I frame/minute) were acquired in a 40~ projection during 60 minutes. The mean apicalseptal p-IPPA washout rate in patients with LBBB during the first 20 minutes was 2 • 3% compared with 11 • 3% in the apical-lateral segment (p
The aim of this work was to determine whether tetrofosmin could be more suitable than sestamibi for pharmacological stress testing in a one-day protocol. Methods: Thirty patients underwent two similar one-day, rest and dipyridamole stress imaging protocols, one using tetrofosmin, the other using sestamibi. SPECT was performed 60 minutes after tracer administration. Images were analyzed both visually and quantitatively. Results: Heart-to-liver activity ratios were higher for tetrofosmin than for sestamibi, both in the resting (1.19i-0.39 vs 0.96!4).45; I><0.05) as in the stress studies (1.37:t:0.37 vs 1.055:0.42; p<0.05). Heart-to-lung ratios were similar for both tracers. In segments showing abnormal uptake during stress, the perfusion indexes were similar with tetrofosmin and sestamibi, as well at rest (66.8%+17.2 vs 66.7%:1:16.4) as at stress (60.5%5:15.7 vs 59.7%+16.6). The degree of'reversibility of these segments was also similar for both tracers (6.3%+7.7 vs 6.9%:~-9.3). The extent, intensity and severity of the perfusion defects were similar in both tracer studies, Conclusions: Our study results indicate that tetrofosmin offers a more optimal biodistribution than sestamibi when used in a one-day, rest and dipyridamole stress imaging setting. However, no difference in quality nor in the diagnostic interpretation of the images could be demonstrated.