Why the study?
Does sublingual glyceryl trinitrate improve the detection of hibernating myocardium using 99Tc(m)-MIBI SPECT imaging in patients with suspected or known myocardial ischaemia?
Does sublingual glyceryl trinitrate improve the detection of hibernating myocardium using 99Tc(m)-MIBI SPECT imaging in patients with suspected or known myocardial ischaemia?
The administration of sublingual nitroglycerine prior to 99Tc(m)-MIBI SPECT imaging can enhance the detection of hibernating myocardium by improving radionuclide uptake in a subset of fixed defects.
GTN may enhance hibernating myocardium detection on MIBI SPECT in select patients; hypothesis-generating and should not yet change imaging protocols.
The purpose of this study was to assess the feasibility of detecting hibernating myocardium using 99Tc(m)-MIBI SPECT imaging following the use of sublingual glyceryl trinitrate (GTN). Thirty-eight subjects were studied, five asymptomatic and 33 with a history of myocardial ischaemia or myocardial infarction (MI). The study was conducted on two separate days, both at rest, one under controlled basal conditions and the other 20 min following the sublingual administration of GTN. A total of 190 cardiac segments were qualitatively analysed and 72 segments with fixed defects were compared to the study following the use of GTN for evidence of improved radionuclide uptake. Following GTN, 73.6% of fixed segment defects showed no change in uptake, 5.5% showed probable improvement whilst in 20.8% a definite enhanced uptake was demonstrated. In 3.7% of segments, worsening of radionuclide uptake was observed.
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Saeed et al. (2001) studied this question.
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