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Annals of Nuclear Medicine
Erschienen in: Annals of Nuclear Medicine 10/2011

01.12.2011 | Original article

Myocardial washout rate of technetium-99m-sestamibi in the chronic phase predicts myocardial damage in patients with previous myocardial infarction

verfasst von: Kohei Ashikaga, Yoshihiro J. Akashi, Kihei Yoneyama, Keisuke Kida, Kengo Suzuki, Fumihiko Miyake

Erschienen in: Annals of Nuclear Medicine | Ausgabe 10/2011

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Abstract

Objective

This study aimed to clarify the correlation between the myocardial washout rate (WR) of technetium-99m hexakis 2-methoxy-isobutyl-isonitrile (99mTc-sestamibi) and cardiac enzyme levels in patients with acute myocardial infarction (AMI) 6 months after the onset.

Methods

Sixty-one consecutive AMI patients (mean age, 66.2 ± 9.7 years) who underwent percutaneous coronary intervention (PCI) on admission were enrolled. Creatinine kinase MB isoenzyme (CK-MB) levels were measured every 3 h. 99mTc-sestamibi myocardial scintigraphic images were obtained at the early (30 min) and delayed (4 h) phases after tracer injection for calculating heart-to-mediastinum (H/M) ratios and global WRs at 2 weeks (0 M) and 6 months (6 M) after the onset of AMI. Regional WRs in the culprit lesions (culprit WR) and the extent score (ES) and severity score (SS) of myocardial damage were also calculated.

Results

PCI was performed 8.3 ± 7.7 h after AMI onset. At 6 M, the early H/M ratio (p = 0.04), delayed H/M ratio (p = 0.02), global WR (p = 0.01), culprit WR (p = 0.002), and delayed ES (p = 0.008) were alleviated. At 0 M, the peak CK-MB level correlated with the delayed H/M ratio (p = 0.003), global WR (p = 0.003), culprit WR (p < 0.001), early ES (p = 0.03), delayed ES (p = 0.01), early SS (p = 0.001), and delayed SS (p < 0.001). At 6 M, the peak CK-MB level correlated with the delayed H/M ratio (p < 0.001), global WR (p = 0.005), culprit WR (p = 0.001), early ES (p = 0.001), delayed ES (p < 0.001), early SS (p < 0.001), and delayed SS (p < 0.001).

Conclusions

These results demonstrated that 99mTc-sestamibi WR in the chronic phase as well as that in the acute phase reflects the extent of initial myocardial damage in AMI patients after PCI. Moreover, it might indicate the myocardial condition in the clinical course.
Literatur
1.
Halkin A, Stone GW, Grines CL, Cox DA, Rutherford BD, Esente P, et al. Prognostic implications of creatine kinase elevation after primary percutaneous coronary intervention for acute myocardial infarction. J Am Coll Cardiol. 2006;47:951–61.PubMedCrossRef
2.
Savonitto S, Granger CB, Ardissino D, Gardner L, Cavallini C, Galvani M, et al. The prognostic value of creatine kinase elevation extends across the whole spectrum of acute coronary syndromes. J Am Coll Cardiol. 2002;39:22–9.PubMedCrossRef
3.
Tsutamoto T, Wada A, Maeda K, Hisanaga T, Maeda Y, Fukai D, et al. Attenuation of compensation of endogenous cardiac natriuretic peptide system in chronic heart failure: prognostic role of plasma brain natriuretic peptide concentration in patients with chronic symptomatic left ventricular dysfunction. Circulation. 1997;96:509–16.PubMed
4.
Katayama T, Nakashima H, Takagi C, Honda Y, Suzuki S, Yano K. Predictors of mortality in patients with acute myocardial infarction and cardiogenic shock. Circ J. 2005;69:83–8.PubMedCrossRef
5.
Paelinck BP, Vrints CJ, Bax JJ, Bosmans JM, De Hert SG, de Roos A, et al. Relation of B-type natriuretic peptide early after acute myocardial infarction to left ventricular diastolic function and extent of myocardial damage determined by magnetic resonance imaging. Am J Cardiol. 2006;97:1146–50.PubMedCrossRef
6.
Richards AM, Nicholls MG, Espiner EA, Lainchbury JG, Troughton RW, Elliott J, et al. B-type natriuretic peptides and ejection fraction for prognosis after myocardial infarction. Circulation. 2003;107:2786–92.PubMedCrossRef
7.
Suzuki S, Yoshimura M, Nakayama M, Mizuno Y, Harada E, Ito T, et al. Plasma level of B-type natriuretic peptide as a prognostic marker after acute myocardial infarction: a long-term follow-up analysis. Circulation. 2004;110:1387–91.PubMedCrossRef
8.
Fertin M, Hennache B, Hamon M, Ennezat PV, Biausque F, Elkohen M, et al. Usefulness of serial assessment of B-type natriuretic peptide, troponin I, and C-reactive protein to predict left ventricular remodeling after acute myocardial infarction (from the REVE-2 study). Am J Cardiol. 2010;106:1410–6.PubMedCrossRef
9.
Christian TF, Behrenbeck T, Gersh BJ, Gibbons RJ. Relation of left ventricular volume and function over one year after acute myocardial infarction to infarct size determined by technetium-99m sestamibi. Am J Cardiol. 1991;68:21–6.PubMedCrossRef
10.
Sciagrà R, Bolognese L, Rovai D, Sestini S, Santoro GM, Cerisano G, et al. Detecting myocardial salvage after primary PTCA: early myocardial contrast echocardiography versus delayed sestamibi perfusion imaging. J Nucl Med. 1999;40:363–70.PubMed
11.
Dong J, Ndrepepa G, Schmitt C, Mehilli J, Schmieder S, Schwaiger M, et al. Early resolution of ST-segment elevation correlates with myocardial salvage assessed by Tc-99m sestamibi scintigraphy in patients with acute myocardial infarction after mechanical or thrombolytic reperfusion therapy. Circulation. 2002;105:2946–9.PubMedCrossRef
12.
Fujiwara S, Takeishi Y, Hirono O, Fukui A, Okuyama M, Ymaguchi S, et al. Reverse redistribution of 99mTc-sestamibi after direct percutaneous transluminal coronary angioplasty in acute myocardial infarction: relationship with wall motion and functional response to dobutamine stimulation. Nucl Med Commun. 2001;22:1223–30.PubMedCrossRef
13.
Kumita S, Seino Y, Cho K, Nakajo H, Toba M, Fukushima Y, et al. Assessment of myocardial washout of Tc-99m-sestamibi in patients with chronic heart failure: comparison with normal control. Ann Nucl Med. 2002;16:237–42.PubMedCrossRef
14.
Byrne RA, Ndrepepa G, Braun S, Tiroch K, Mehilli J, Schulz S, et al. Peak cardiac troponin-T level, scintigraphic myocardial infarct size and one-year prognosis in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction. Am J Cardiol. 2010;106:1212–7.PubMedCrossRef
15.
Tzivoni D, Koukoui D, Guetta V, Novack L, Cowing G. Comparison of Troponin T to creatine kinase and to radionuclide cardiac imaging infarct size in patients with ST-elevation myocardial infarction undergoing primary angioplasty. Am J Cardiol. 2008;101:753–7.PubMedCrossRef
16.
Chia S, Senatore F, Raffel OC, Lee H, Wackers FJ, Jang IK. Utility of cardiac biomarkers in predicting infarct size, left ventricular function, and clinical outcome after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. JACC Cardiovasc Interv. 2008;1:415–23.PubMedCrossRef
17.
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;82:1826–38.PubMedCrossRef
18.
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;31:1646–53.PubMed
19.
Akashi YJ, Ashikaga K, Takano M, Izumo M, Ishibashi Y, Kida K, et al. Significance of 99mTc-Sestamibi myocardial scintigraphy after percutaneous coronary intervention in patients with acute myocardial infarction. Med Sci Monit. 2011;17:CR140–5.PubMed
20.
Sezer M, Cimen AO, Aslanger EK, Yormaz E, Turkmen C, Umman B, et al. Infarct remodeling process during long-term follow-up after reperfused acute myocardial infarction. Am J Med Sci. 2009;338:465–9.PubMedCrossRef
21.
Tanaka R, Nakamura T. Time course evaluation of myocardial perfusion after reperfusion therapy by 99mTc-tetrofosmin SPECT in patients with acute myocardial infarction. J Nucl Med. 2001;42:1351–8.PubMed
22.
Liu Z, Okada DR, Johnson G, Hocherman SD, Beju D, Okada RD. 99mTc-sestamibi kinetics predict myocardial viability in a perfused rat heart model. Eur J Nucl Med Mol Imaging. 2008;35:570–8.PubMedCrossRef
23.
Thompson PL, Fletcher EE, Katavatis V. Enzymatic indices of myocardial necrosis: influence on short- and long-term prognosis after myocardial infarction. Circulation. 1979;59:113–9.PubMed
24.
Weinstein H, Reinhardt CP, Wironen JF, Leppo JA. Myocardial uptake of thallium 201 and technetium 99m-labeled sestamibi after ischemia and reperfusion: comparison by quantitative dual-tracer autoradiography in rabbits. J Nucl Cardiol. 1994;1:351–64.PubMedCrossRef
25.
Merlet P, Valette H, Dubois-Randé JL, Moyse D, Duboc D, Dove P, et al. Prognostic value of cardiac metaiodobenzylguanidine imaging in patients with heart failure. J Nucl Med. 1992;33:471–7.PubMed
26.
Nakajima K, Taki J, Tonami N, Hisada K. Decreased 123I-MIBG uptake and increased clearance in various cardiac diseases. Nucl Med Commun. 1994;15:317–23.PubMedCrossRef
27.
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;33:1516–22.PubMed
28.
Arbab AS, Koizumi K, Toyama K, Arai T, Araki T. Technetium- 99m-tetrofosmin, technetium-99m-MIBI and thallium-201 uptake in rat myocardial cells. J Nucl Med. 1998;39:266–71.PubMed
29.
Matsuo S, Nakae I, Tsutamoto T, Okamoto N, Horie M. A novel clinical indicator using Tc-99m sestamibi for evaluating cardiac mitochondrial function in patients with cardiomyopathies. J Nucl Cardiol. 2007;14:215–20.PubMedCrossRef
30.
Isobe S, Ohshima S, Unno K, Izawa H, Kato K, Noda A, et al. Relation of 99mTc-sestamibi washout with myocardial properties in patients with hypertrophic cardiomyopathy. J Nucl Cardiol. 2010;17:1082–90.PubMedCrossRef
31.
Madamanchi NR, Runge MS. Mitochondrial dysfunction in atherosclerosis. Circ Res. 2007;100:460–73.PubMedCrossRef
Metadaten
Titel
Myocardial washout rate of technetium-99m-sestamibi in the chronic phase predicts myocardial damage in patients with previous myocardial infarction
verfasst von
Kohei Ashikaga
Yoshihiro J. Akashi
Kihei Yoneyama
Keisuke Kida
Kengo Suzuki
Fumihiko Miyake
Publikationsdatum
01.12.2011
Verlag
Springer Japan
Erschienen in
Annals of Nuclear Medicine / Ausgabe 10/2011
Print ISSN: 0914-7187
Elektronische ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-011-0519-6

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