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Prediction of functional recovery after revascularization in patients with chronic ischaemic left ventricular dysfunction: head-to-head comparison between 99mTc-sestamibi/18F-FDG DISA SPECT and 13N-ammonia/18F-FDG PET

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Abstract

Purpose

18F-FDG PET is an important modality for myocardial viability assessment in patients with left ventricular (LV) dysfunction. Dual-isotope simultaneous acquisition (DISA) SPECT may be an alternative to PET. The aim of this study was to compare the diagnostic performance of PET and DISA SPECT for the prediction of improvement in regional and global LV function as well as LV reverse remodelling after revascularization.

Methods

Patients (n=47) with chronic coronary artery disease and LV dysfunction underwent DISA SPECT (with 99mTc-sestamibi and 18F-FDG) and PET (with 13N-ammonia and 18F-FDG) on the same day to assess viability. All patients underwent revascularization and recovery of function was derived from serial magnetic resonance imaging studies.

Results

Of 264 revascularized, dysfunctional segments, 143 (54%) improved in function. For prediction of improvement in regional LV function, PET and DISA SPECT had similar sensitivity (90% versus 89%, NS) and specificity (86% versus 86%, NS). For prediction of improvement in global LV function, sensitivity was 83% for DISA SPECT and 86% for PET (p=NS), whereas both modalities had a specificity of 100%. Finally, sensitivity and specificity for the prediction of LV reverse remodelling were also similar for DISA SPECT and PET.

Conclusion

In patients undergoing revascularization, DISA SPECT and PET predict the improvement in regional and global LV function and LV remodelling equally well post revascularization.

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Acknowledgements

This study was supported by an educational unrestricted research grant (COG-AZG 2000-06) of the Groningen University Medical Center, The Netherlands. Dr. D.J. van Veldhuisen is an Established Investigator of the Netherlands Heart Foundation (Grant D976.017).

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Authors and Affiliations

  1. Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, P.O. Box 30001, Hanzeplein 1, 9700 RB, Groningen, The Netherlands

    Riemer H.J.A. Slart, Rudi A. Dierckx & Pieter L. Jager

  2. Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands

    Jeroen J. Bax & Ernst E van der Wall

  3. Department of Cardiology, University Medical Center Groningen,, Groningen, The Netherlands

    Dirk J. van Veldhuisen

  4. Department of Radiology, University Medical Center Groningen,, Groningen, The Netherlands

    Roy Irwan

  5. Department of Endocrinology, University Medical Center Groningen,, Groningen, The Netherlands

    Wim J. Sluiter

  6. Department of Nuclear Medicine, Diaconessenhuis Meppel,, Meppel, The Netherlands

    Jaep de Boer

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  1. Riemer H.J.A. Slart
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  2. Jeroen J. Bax
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Correspondence to Riemer H.J.A. Slart.

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Slart, R.H., Bax, J.J., van Veldhuisen, D.J. et al. Prediction of functional recovery after revascularization in patients with chronic ischaemic left ventricular dysfunction: head-to-head comparison between 99mTc-sestamibi/18F-FDG DISA SPECT and 13N-ammonia/18F-FDG PET. Eur J Nucl Med Mol Imaging 33, 716–723 (2006). https://doi.org/10.1007/s00259-005-0016-z

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