Claeys M J, Vrints C J, Krug B, Bosmans J M, Blockx P P, Bossaert L L, Snoeck J P
Department of Cardiology, Antwerp University Hospital, University of Antwerp (UIA), Belgium.
Eur Heart J. 1995 Sep;16(9):1186-94. doi: 10.1093/oxfordjournals.eurheartj.a061074.
The purpose of this study was to evaluate the accuracy of adenosine Tc-99m sestamibi single photon emission computed tomography (SPECT) in the detection of jeopardized myocardium early after acute myocardial infarction. Coronary arteriography and myocardial scintigraphy were performed in 50 consecutive patients with an uncomplicated myocardial infarction. Myocardium was considered jeopardized if a significant infarct-related vessel stenosis (> 50% diameter stenosis) supplied an infarct area with residual viable tissue. Perfusion reversibility in the infarct region occurred in 25 patients (50%) and was almost solely observed in the presence of jeopardized myocardium. Non-reversible perfusion defects in the infarct region were found in patients without jeopardized myocardium. This subgroup consisted of either patients without significant vessel stenosis or patients without significant residual viability in the infarct region. Adenosine Tc-99m sestamibi SPECT had an accuracy of 88% for the detection of jeopardized myocardium. Side effects during adenosine infusion were frequently observed but well tolerated. These results suggest that adenosine Tc-99m sestamibi SPECT is an accurate non-invasive method for detecting jeopardized myocardium after acute myocardial infarction and may be a valuable non-invasive test for the early selection of patients at risk for future ischaemic events.
本研究的目的是评估锝-99m甲氧基异丁基异腈单光子发射计算机断层扫描（SPECT）检测急性心肌梗死后早期濒危心肌的准确性。对50例无并发症的心肌梗死患者连续进行冠状动脉造影和心肌闪烁显像。如果有显著的梗死相关血管狭窄（直径狭窄>50%）为有存活心肌残留的梗死区域供血，则认为心肌处于濒危状态。梗死区域的灌注可逆性发生在25例患者（50%）中，且几乎仅在存在濒危心肌时观察到。在没有濒危心肌的患者中发现梗死区域存在不可逆的灌注缺损。该亚组包括无显著血管狭窄的患者或梗死区域无显著存活心肌的患者。锝-99m甲氧基异丁基异腈SPECT检测濒危心肌的准确率为88%。腺苷输注期间的副作用经常出现，但耐受性良好。这些结果表明，锝-99m甲氧基异丁基异腈SPECT是检测急性心肌梗死后濒危心肌的一种准确的非侵入性方法，可能是早期筛选未来有缺血事件风险患者的一种有价值的非侵入性检查。
