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Clinical and research medicine: Coronary heart disease
e0374 Comparison of treadmill exercise test and 99mTcMIBI18FFDG myocardial SPECT image for identifying viable myocardium in patients with old myocardial infarction
  1. Li Lin,
  2. Gao Ning,
  3. Liu Jian,
  4. Tang Yaming,
  5. Guo Tao
  1. The First Affiliated Hospital of Kunming Medical College


Objective The aim of this study was to investigate the correlation between myocardial viability in old myocardial infarction as assessed by treadmill exercise test and 99mTc-MIBI/18F-FDG dual isotope simultaneous acquisition of single photon emission CT (SPECT).

Methods 15 consecutive patients (13 males, 2 females, mean age 55±8years) with old myocardial infarction were included in this study. All patients underwent coronary arteriography, maximal treadmill exercise testing and 99Tcm-MIBI/18F-FDG SPECT. Patients were classified into myocardial viability group and non myocardial viability group according to 99Tcm-MIBI/18F-FDG SPECT. The semi-quantitative scoring system was used for SPECT images. Myocardial viability was defined as an improvement of perfusion at least >1 grade in at least two contiguous segments during 18F-FDG SPECT. The indices of treadmill exercise testing were measured and compared in myocardial viability and non myocardial viability groups. Compared with the results of 99Tcm-MIBI/18F-FDG SPECT, the sensitivity and specificity of these indices for detecting of myocardial viability were calculated.

Results 8 out of the 15 studied patients were defined as myocardial viability group, and the rest of 7 patients were in non myocardial viability group. 7 out of 8 (87%) patients in myocardial viability group were accompanied with exercise-induced Q-wave prolongation. Myocardial viability was detected more often in patients with smaller QT dispersion (≤70 ms). Q-wave prolongation had well consistency with 99mTc-MIBI/18F-FDG SPECT for detecting myocardial viability (x2=8.04, p =0.009). The sensitivities, specificities, positive predictive values, and negative predictive values of Q-wave prolongation and QT dispersion ≤70 ms for evaluating myocardial viability were 87.5%, 85.6%, 87.5%, 85.6% and 75.0%, 71.4%, 75.0%, and 71.4%, respectively.

Conclusion In patients with old myocardial infarction, exercise-induced Q-wave prolongation and QT dispersion were related to myocardial viability identified with 99Tcm-MIBI/18F-FDG SPECT. Exercise-induced Q-wave prolongation and QT dispersion were found to be the sensitive and specific ECG marker for detecting of myocardial viability.

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