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Dobutamine stress-redisstribution-reinjection versus rest-redistribution thallium-201 spect in the assessment of myocardial viability

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Abstract

The aim of this study was to evaluate the value of thallium-201 chloride (201Tl) reinjection imaging following dobutamine stress (DRi) to identify viable myocardium in comparison with a rest-redistribution 201Tl protocol (RR). The identification of viable myocardium bears important consequences for adequate selection of patients with poor left ventricular function, often unable to exercise, who are considered for revascularization. Twenty-six patients with chronic coronary artery disease and depressed left ventricular function (ejection fraction 36±10%) were studied by both DRi and RR single photon emission computed tomography (SPECT). Semi-quantitative analysis of regional 201Tl activity (5-point score) and wall motion by echocardiography using a 16-segment model was performed. Regions were classified as viable (normal/reversible/fixed moderate defects) or non-viable (fixed severe defects) and related to regional wall motion. Target heart rate was reached in 25 patients. Myocardial viability was demonstrated in 353/416 (85%) by DRi SPECT and in 346/416 (83%) by RR SPECT. The agreement between the 2 protocols was 98% with a K-value of 0.94; similar results were obtained when the analysis was limited to dyscontractile segments. In conclusion, this study demonstrates the feasibility and diagnostic value of DRi SPECT to identify viable myocardium.

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Authors and Affiliations

  1. Division of Cardiology, Thoraxcenter, The Netherlands

    Jan H. Cornel, Abdou Elhendy & Paolo M. Fioretti

  2. Dept of Cardiology, Medical Center Alkmaar, 1815 JD, Alkmaar, The Netherlands

    Jan H. Cornel

  3. Dept. of Cardiology, University Hospital, Leiden, The Netherlands

    Jeroen J. Bax

  4. Dept of Nuclear Medicine, University Hospital Rotterdam-Dijkzigt, Rotterdam, The Netherlands

    Ambroos E.M. Reijs

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  1. Jan H. Cornel
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  2. Jeroen J. Bax
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  4. Ambroos E.M. Reijs
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  5. Paolo M. Fioretti
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Cornel, J.H., Bax, J.J., Elhendy, A. et al. Dobutamine stress-redisstribution-reinjection versus rest-redistribution thallium-201 spect in the assessment of myocardial viability. Int J Cardiovasc Imaging 13, 59–64 (1997). https://doi.org/10.1023/A:1005732802777

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