Citron B, Lipiecki J, Maublant J, Mestas D, Camilieri L, Veyre A, de Riberolles C, Ponsonnaille J
Service de cardiologie et chirurgie cardiovasculaire, hôpital Gabriel-Montpied, Clermont-Ferrand.
Arch Mal Coeur Vaiss. 1995 Jun;88(6):833-40.
The aim of this study was to assess the value of resting 99m Tc-Sestamibi scintigraphy for the detection of hibernating myocardium in zones of contractile dysfunction. Based on a series of 25 patients, 27 segments of supposedly hibernating myocardium were identified. All these segments corresponded to left ventricular wall motion abnormalities confirmed by contrast angiography and were perfused by a stenosed coronary artery: none of these zones were infarcted. Before revascularisation, comparison of the results of ventriculography and scintigraphy showed a correlation (p < 0.001) between the severity of regional contractile dysfunction appreciated by the center line method and the degree of myocardial hypofixation of 99m Tc MIBI. Three months after revascularisation, improvement of regional wall motion, assessed by control contrast angiography, was observed in 21 of the 27 segments studied (78%). Of these 21 segments, the viability of which was confirmed, 13 had a non-transmural uptake defect and 8 were normal on pre-revascularisation scintigraphy. The 6 segments without improvement at the 3 month control, had a transmural uptake defect on scintigraphy in 67% of cases. The authors concluded that when a residual uptake defect of 99m Tc sestamibi is present, viable myocardium may also be present.
本研究的目的是评估静息状态下99m锝-甲氧基异丁基异腈（99m Tc-Sestamibi）心肌灌注显像对检测收缩功能障碍区域冬眠心肌的价值。基于25例患者，共识别出27个推测为冬眠心肌的节段。所有这些节段均对应于经造影剂血管造影证实的左心室壁运动异常，并由狭窄的冠状动脉供血：这些区域均无梗死。在血运重建前，心室造影和心肌灌注显像结果的比较显示，通过中心线法评估的局部收缩功能障碍的严重程度与99m Tc MIBI心肌摄取减低程度之间存在相关性（p < 0.001）。血运重建三个月后，在研究的27个节段中的21个（78%）观察到通过对照造影剂血管造影评估的局部室壁运动改善。在这些21个节段中，其存活能力得到证实，其中13个在血运重建前的心肌灌注显像中有非透壁性摄取缺损，8个正常。在3个月的对照中无改善的6个节段，67%在心肌灌注显像中有透壁性摄取缺损。作者得出结论，当存在99m Tc sestamibi的残余摄取缺损时，也可能存在存活心肌。
