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Assessment of myocardial washout of Tc-99m-sestamibi in patients with chronic heart failure: Comparison with normal control

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Abstract

Background

In contrast to201T1C1,99mTc-sestamibi shows very slow myocardial clearance after its initial myocardial uptake. In the present study, myocardial washout of99mTc-sestamibi was calculated in patients with non-ischemic chronic heart failure (CHF) and compared with biventricular parameters obtained from first-pass and ECG-gated myocardial perfusion SPECT data.

Methods and Results

After administration of99mTc-sestamibi, 25 patients with CHF and 8 normal controls (NC) were examined by ECG-gated myocardial perfusion SPECT and planar data acquisition in the early and delayed (interval of 3 hours) phase. Left ventricular ejection fraction (LVEF, %), peak filling rate (PFR, sec−1), end-diastolic volume (LVEDV, ml) and end-systolic volume (LVESV, ml) were automatically calculated from the ECG-gated SPECT data. Myocardial washout rates over 3 hours were calculated from the early and delayed planar images. Myocardial washout rates in the CHF group (39.6±5.2%) were significantly higher than those in the NC group (31.2±5.5%, p<0.01). The myocardial washout rates for the 33 subjects showed significant correlations with LVEF (r=−0.61, p<0.001), PFR (r=−0.47, p<0.01), LVEDV (r=0.45, p<0.01) and LVESV (r=48, p<0.01),Conclusion: The myocardial washout rate of99mTc-sestamibi is considered to be a novel marker for the diagnosis of myocardial damage in patients with chronic heart failure.

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References

  1. Li Q-S, Frank TL, Franceschi D, Wagner HN, Becker LC. Technetium-99m methoxyisobutyl isonitrile (RP30) for quantification of myocardial ischemia and reperfusion in dogs.J Nucl Med 1988; 29: 1539–1548.

    PubMed  CAS  Google Scholar 

  2. Sinusas AJ, Bergin JD, Edwards NC, Watson DD, Ruiz M, Makch RW, et al. Redistribution of99mTc-sestamibi and201Tl in the presence of a severe coronary artery stenosis.Circulaton 1994; 89: 2332.

    CAS  Google Scholar 

  3. Meyer JV, Mena I, Narahara K. Simultaneous assessment of left ventricular wall motion and myocardial perfusion with Technetium-99m-methoxy isobutyl isonitrile at stress and rest in patients with angina: comparison with Thallium-201 SPECT.J Nucl Med 1990; 31: 457–463.

    Google Scholar 

  4. Jones RH, Borges-Neto S, Potts JM. Simultaneous measurement of myocardial perfusion and ventricular function during exercise from a single injection of technetium-99m sestamibi in coronary artery disease.Am J Cardiol 1990; 66: 68E-71E.

    Article  PubMed  CAS  Google Scholar 

  5. Grucker D, Florentz P, Ozwald T, Chambron J. Myocardial gated tomoscintigraphy with99mTc-methoxy isobutyl isonitrile (MIBI): regional and temporal activity curve analysis.Nucl Med Commun 1989; 10: 723–732.

    Article  PubMed  CAS  Google Scholar 

  6. Marcassa C, Marzullo P, Parodi O, Sambuceti G, L’Abbate A. A new method for noninvasive quantitation of segmental myocardial wall thickening using99mTc-2-methoxy-isobutyl-isonitrile scintigraphy: results in normal subjects.J Nucl Med 1990; 31: 173–177.

    PubMed  CAS  Google Scholar 

  7. Faber TL, Akers MS, Peshock RM, Corbett JR. Three-dimensional motion and perfusion quantification in gated single-photon emission computed tomograms.J Nucl Med 1991; 32: 2311–2317.

    PubMed  CAS  Google Scholar 

  8. DePuey NG, Nichols K, Dobrinsky C. Left ventricular ejection fraction assessed from gated technetium-99m-sestamibi SPECT.J Nucl Med 1993; 34: 1871–1876.

    PubMed  CAS  Google Scholar 

  9. Williams KA, Taillon LA. Left ventricular function in patients with coronary artery disease assessed by gated tomographic myocardial perfusion images.J Am Coll Cardiol 1996; 27: 173–181.

    Article  PubMed  CAS  Google Scholar 

  10. Germano G, Kavanagh P, Su HT, Mazzanti M, Kiat H, Hachamoritch R, et al. Automatic reorientation of three-dimensional transaxial myocardial perfusion SPECT images.J Nucl Med 1995; 36: 1107–1114.

    PubMed  CAS  Google Scholar 

  11. Germano G, Kiat H, Kavanagh P, Moriei M, Mazzanti M, Su HT, et al. Automatic quantification of ejection fraction from gated myocardial perfusion SPECT.J Nucl Med 1995; 36: 2138–2147.

    PubMed  CAS  Google Scholar 

  12. Kumita S, Cho K, Nakajo H, Toba M, Uwamori M, Mizumura S, et al. Assessment of left ventricular diastolic function using ECG-gated myocardial perfusion SPECT: comparison with multigated equilibrium radionuclide angiography.J Nucl Cardiol 2001; 8: 568–574.

    Article  PubMed  CAS  Google Scholar 

  13. Chiu ML, Kronauge JF, Piwnica-Worms D. Effect of mitochondrial and plasma membrane potentials on accumulation of hexakis (2-methoxyisobutylisonitrile) technetium (I) in cultured mouse fibroblasts.J Nucl Med 1990; 31: 1646–1653.

    PubMed  CAS  Google Scholar 

  14. Piwnica-Worms D, Kronauge JF, Chiu ML. Uptake and retention of hexakis (2-methoxyisobutyl isonitrile) technetium (I) in cultured chick myocardial cells. Mitochondrial and plasma membrane potential dependence.Circulation 1990; 82: 1826–1838.

    PubMed  CAS  Google Scholar 

  15. Beanlands RS, Dawood F, Wen WH, McLaughlin PR, Butany J, D’Amati G, et al. Are the kinetics of technetium-99m methoxyisobutyl isonitrile affected by cell metabolism and viability?Circulation 1990; 82: 1802–1814.

    PubMed  CAS  Google Scholar 

  16. Carvalho PA, Chiu ML, Kronauge JF, Kawamura M, Jones AG, Holman BL, et al. Subcellular distribution and analysis of technetium-99m-MIBI in isolated perfused rat hearts.J Nucl Med 1992; 33: 1516–1521.

    PubMed  CAS  Google Scholar 

  17. Crane P, Laiberte R, Heminway S, Thoolen M, Orlandi C. Effect of mitochondrial viability and metabolism on technetium-99m sestamibi myocardial retention.Eur J Nucl Med 1993; 20: 20–25.

    Article  PubMed  CAS  Google Scholar 

  18. Wackers FJ Th, Berman DS, Maddahi J, Watson DD, Beller GA, Strauss W, et al. Technetium-99m hexakis 2-methoxyisobutyl isonitrile: human biodistribution, dosimetry, safety, and preliminary comparison to thallium-201 for myocardial perfusion imaging.J Nucl Med 1989; 30: 301–311.

    PubMed  CAS  Google Scholar 

  19. Shin WJ, Miller K, Stipp V, Mazour S. Reverse redistribution on dynamic exercise and dipyridamole stress technetium-99m-MIBI myocardial SPECT.J Nucl Med 1995; 36: 2053–2055.

    Google Scholar 

  20. Takeishi Y, Sukekawa H, Fujiwara S, Ikeno E, Sasaki Y, Tomoike H, et al. Reverse redistribution of technetium-99m-sestamibi following direct PTCA in acute myocardial infraction.J Nucl Med 1996; 37: 1289–1294.

    PubMed  CAS  Google Scholar 

  21. Fujiwara S, Takeishi Y, Atsumi H, Yamaki M, Takahashi N, Yamaoka M, et al. Prediction of functional recovery in acute myocardial infarction: comparison between sestamibi reverse redistribution and sestamibi/BMIPP mismatch.J Nucl Cardiol 1998; 5: 119–127.

    Article  PubMed  CAS  Google Scholar 

  22. Jaffe AS, Ravkilde I, Roberts R, Naslund U, Apple FS, Galvani M, et al. It’s time for a change to a troponin standard.Circulation 2000; 102: 1216–1220.

    PubMed  CAS  Google Scholar 

  23. Missiv E, Calzolari C, Pau B. Circulating cardiac troponin I in severe congestive heart failure.Circulation 1997; 96: 2953–2958.

    Google Scholar 

  24. Setsuta K, Seino Y, Takahashi N, Ogawa T, Sasaki K, Harada A, et al. Clinical significance of elevated levels of cardiac troponin T in patients with chronic heart failure.Am J Cardiol 1999; 84: 608–611.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyoku, 113-8603, Tokyo, Japan

    Shin-ichiro Kumita, Keiichi Cho, Hidenobu Nakaio, Masahiro Toba, Yoshimitsu Fukushima & Tatsuo Kumazaki

  2. First Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyoku, 113-8603, Tokyo, Japan

    Yoshihiko Seino & Teruo Takano

  3. Medical Imaging, Bristol-Myers Squibb K.K., Tokyo, Japan

    Noriake Okamoto

Authors
  1. Shin-ichiro Kumita
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  2. Yoshihiko Seino
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  3. Keiichi Cho
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  4. Hidenobu Nakaio
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  5. Masahiro Toba
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  6. Yoshimitsu Fukushima
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  7. Noriake Okamoto
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  8. Teruo Takano
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  9. Tatsuo Kumazaki
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Correspondence to Shin-ichiro Kumita.

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Kumita, Si., Seino, Y., Cho, K. et al. Assessment of myocardial washout of Tc-99m-sestamibi in patients with chronic heart failure: Comparison with normal control. Ann Nucl Med 16, 237–242 (2002). https://doi.org/10.1007/BF03000101

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  • DOI: https://doi.org/10.1007/BF03000101

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