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December 1, 2002Nuclear Medicine Communications

Pulsed Doppler tissue imaging for the assessment of myocardial viability: comparison with 99mTc sestamibi perfusion imaging

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Why the study?

Does pulsed Doppler tissue imaging provide comparable diagnostic accuracy to 99mTc sestamibi perfusion imaging for detecting myocardial viability in patients with old myocardial infarction undergoing PTCA?

Population

30 patients with old myocardial infarction who underwent percutaneous transluminal coronary angioplasty.

Comparison

Pulsed Doppler tissue imaging performed within 7… vs Myocardial single photon emission computed…

Design

Cohort

Follow-up

3 months

Authors

OMOsamu MinamihabaYamagata UniversityYTYasuchika TakeishiHeart Failure & TransplantOHOsamu HironoUniversity of Toyama

Discussion

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Implication

May offer echocardiographic alternative for viability assessment pre-PTCA; leaves open need for prospective validation versus perfusion imaging.

Key Points

  • To evaluate the diagnostic performance of Doppler tissue imaging in detecting viable myocardium compared to myocardial perfusion imaging with Tc-MIBI.
  • Studied 30 patients with old myocardial infarction undergoing PTCA.
  • Performed myocardial SPECT with Tc-MIBI and two-dimensional echocardiography before PTCA.
  • Measured peak systolic velocity and PEP/ET from Doppler imaging, and assessed wall motion improvement post-intervention.
  • Peak systolic velocity showed a positive correlation with Tc-MIBI uptake (R=0.59, P<0.01).
  • PEP/ET had an inverse correlation with Tc-MIBI uptake (R=-0.59, P<0.01).
  • Doppler imaging showed 80% diagnostic accuracy for peak systolic velocity and 79% for PEP/ET compared to 90% for Tc-MIBI.

Structured PICO

Does pulsed Doppler tissue imaging provide comparable diagnostic accuracy to 99mTc sestamibi perfusion imaging for detecting myocardial viability in patients with old myocardial infarction undergoing PTCA?

P
Population
30 patients with old myocardial infarction who underwent percutaneous transluminal coronary angioplasty (PTCA).
I
Intervention
Pulsed Doppler tissue imaging (measuring regional peak systolic velocity and regional pre-ejection period to regional ejection time ratio [PEP/ET]) performed within 7 days before PTCA.
C
Comparator
Myocardial single photon emission computed tomography (SPECT) with 99mTc hexakis-2-methoxyisobutylisonitrile (MIBI) performed within 7 days before PTCA.
O
Outcome
Diagnostic accuracy for detecting viable myocardium (defined as wall motion improvement of at least one grade on biplane left ventriculography 3 months after PTCA).surrogate

Pulsed Doppler tissue imaging provides a useful, quantitative echocardiographic alternative to Tc-MIBI SPECT for assessing myocardial viability prior to revascularization.

Cite This Study

Minamihaba et al. (2002) studied this question.

synapsesocial.com/papers/6a196845f3c200df10585342https://doi.org/10.1097/00006231-200212000-00008
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Doppler Tissue Imaging Quantitates Regional Wall Motion During Myocardial Ischemia and Reperfusion1998 · 318 citations
  2. 2The stunned myocardium: prolonged, postischemic ventricular dysfunction.1982 · 2,819 citations
  3. 3Myocardial kinetics of technetium-99m-hexakis-2-methoxy-2-methylpropyl-isonitrile.1988 · 381 citations
  4. 4Myocardial viability in patients with chronic coronary artery disease. Comparison of 99mTc-sestamibi with thallium reinjection and [18F]fluorodeoxyglucose.1994 · 272 citations