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Assessment of myocardial viability by dynamic tomographic iodine 123 iodophenylpentadecanoic acid imaging: Comparison with rest-redistribution thallium 201 imaging

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

This study examined the ability of dynamic 123I-labeled iodophenylpentade-canoic acid (IPPA) imaging to detect myocardial viability in patients with left ventricular (LV) dysfunction caused by coronary artery disease.

Methods and Results

Serial 180-degree single-photon emission computed tomographic (SPECT) images (five sets, 8 minutes each) were obtained starting 4 minutes after injection of 2 to 6 mCi 123I at rest in 21 patients with LV dysfunction (ejection fraction [EF] 34%±11%). The segmental uptake was compared with that of rest-redistribution 201Tl images (20 segments/study). The number of perfusion defects (reversible and fixed) was similar by IPPA and thallium (11±5 vs 10±5 segments/patient; difference not significant). There was agreement between IPPA and thallium for presence or absence (κ=0.78±0.03) and nature (reversible, mild fixed, or severe fixed) of perfusion defects (κ=0.54±0.04). However, there were more reversible IPPA defects than reversible thallium defects (7±4 vs 3±4 segments/patient; p=0.001). In 14 patients the EF (by gated pool imaging) improved after coronary revascularization from 33%±11% to 39%±12% (p=0.002). The number of reversible IPPA defects was greater in the seven patients who had improvement in EF than in the patients without such improvement (10±4 vs 5±4 segments/patient; p=0.075).

Conclusions

123I-labeled IPPA SPECT imaging is a promising new technique for assessment of viability. Reversible defects predict recovery of LV dysfunction after coronary revascularization.

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Authors and Affiliations

  1. Presbyterian Medical Center, Philadelphia Heart Institute, 51 N. 39th St., 19104, Philadelphia, PA

    Abdulmassih S. Iskandrian, Joseph Powers, Virginia Cave, Valerie Wasserleben, David Cassell & Jaekyeong Heo

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  1. Abdulmassih S. Iskandrian
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  2. Joseph Powers
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  3. Virginia Cave
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  4. Valerie Wasserleben
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  6. Jaekyeong Heo
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Supported in part by research grants from Medco Research, Inc.

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Iskandrian, A.S., Powers, J., Cave, V. et al. Assessment of myocardial viability by dynamic tomographic iodine 123 iodophenylpentadecanoic acid imaging: Comparison with rest-redistribution thallium 201 imaging. J Nucl Cardiol 2, 101–109 (1995). https://doi.org/10.1016/S1071-3581(95)80020-4

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  • DOI: https://doi.org/10.1016/S1071-3581(95)80020-4

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