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Effects of myocardial revascularization on regional thallium-201 uptake and systolic function in regions with reverse redistribution on tomographic thallium-201 imaging at rest in patients with chronic coronary artery disease

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Journal of Nuclear Cardiology Aims and scope

Abstract

Objectives

There is growing evidence that myocardial segments with reverse redistribution are viable in patients with chronic coronary artery disease. The aim of this study was to assess the effects of myocardial revascularization on systolic function and thallium-201 uptake in such segments.

Methods

Rest-redistribution thallium-201 tomography before and after myocardial revascularization was performed in 47 patients with chronic coronary artery disease. Regional function was evaluated by two-dimensional echocardiography before and after revascularization according to a 3-point scale (1=normal, 2=hypokinetic, 3=a/dyskinetic). Improvement of dysfunctional segments was defined when systolic function score decreased ≥1 after revascularization. Reverse redistribution was defined as ≥8% decrease in relative thallium-201 uptake between rest and redistribution images.

Results

Reverse redistribution was found in 27 (57%) of 47 patients, corresponding to 60 (11%) of 564 myocardial segments. Of such segments, 24 (40%) had normal systolic function, 19 (32%) were hypokinetic, and 17 (28%) were a/dyskinetic. Thirty-six segments underwent myocardial revascularization, and reverse redistribution was no longer present in 86% of them subsequent to the procedure. Of 26 dyssynergic segments with reverse redistribution subjected to revascularization, 18 (69%) improved at follow-up.

Conclusions

The findings of the present study indicate that reverse redistribution is a reversible phenomenon and is often associated with improvement of systolic function following revascularization in patients with chronic coronary artery disease.

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Authors and Affiliations

  1. Cattedra di Medicina Nucleare, Istituto di Scienze Radiologiche, Facoltà di Medicina e Chirurgia, Università Federico II, Federico, Italy

    Leonardo Pace, Pier Paolo Mainenti, Alberto Cuocolo, Andrea Varrone, Andrea Soricelli & Marco Salvatore

  2. Cattedra di Cardiologia, Istituto di Scienze Radiologiche, Facoltà di Medicina e Chirurgia, Università Federico II, Federico, Italy

    Pasquale Perrone-Filardi, Mariella Prastaro, Pasquale Vezzuto, Teresa Crisci, Federico Piscione & Massimo Chiariello

  3. Centro C.N.R. per la Medicina Nucleare, trav. priv. Sanseverino 5/A, 80128, Napoli, Italy

    Leonardo Pace, Pier Paolo Mainenti, Alberto Cuocolo, Andrea Varrone, Andrea Soricelli & Marco Salvatore

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  1. Leonardo Pace
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  2. Pasquale Perrone-Filardi
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  3. Pier Paolo Mainenti
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  4. Mariella Prastaro
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  5. Alberto Cuocolo
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  6. Andrea Varrone
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  7. Pasquale Vezzuto
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  8. Teresa Crisci
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  9. Andrea Soricelli
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  10. Federico Piscione
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  11. Massimo Chiariello
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  12. Marco Salvatore
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Pace, L., Perrone-Filardi, P., Mainenti, P.P. et al. Effects of myocardial revascularization on regional thallium-201 uptake and systolic function in regions with reverse redistribution on tomographic thallium-201 imaging at rest in patients with chronic coronary artery disease. J Nucl Cardiol 5, 153–160 (1998). https://doi.org/10.1016/S1071-3581(98)90198-2

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  • DOI: https://doi.org/10.1016/S1071-3581(98)90198-2

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