Key result
Cardiac pathology is linked to an accelerated 99mTc-MIBI washout rate vs. controls.
Why the study?
The assessment of myocardial mitochondrial dysfunction using 99mTc-MIBI washout rate has been studied experimentally and clinically, but a systematic synthesis and meta-analysis of clinical data were lacking.
Does the presence of cardiac pathologies accelerate the 99mTc-MIBI washout rate compared to controls?
Meta-Analysis (n=196)
Does the presence of cardiac pathologies accelerate the 99mTc-MIBI washout rate compared to controls?
Mean Difference: 9.5771 (95% CI 6.6001–12.554)
p-value: p=<0.0001
Accelerated 99mTc-MIBI washout can serve as an in vivo marker for assessing myocardial mitochondrial dysfunction in cardiovascular diseases.
May support 99mTc-MIBI washout as a mitochondrial dysfunction marker; leaves open prospective validation before clinical adoption.
BACKGROUND: This review outlines the features of the pharmacokinetics of the perfusion radiopharmaceutical 99mTc-MIBI, which allows the assessment of myocardial mitochondrial dysfunction, and shows the main clinical applications of the phenomenon of increased 99mTc-MIBI washout rate. AIM: To systematize the data of fundamental (experimental) and clinical studies evaluating and estimating mitochondrial dysfunction according to myocardial perfusion scintigraphy data and perform meta-analysis of clinical studies in this field. MATERIALS AND METHODS: PubMed, Scopus, Google Scholar, and eLibrary databases were searched until mid-2023. The following keywords, their combinations, and Russian-language counterparts were used: mitochondrial dysfunction, 99mTc-MIBI, 99mTc-Tetrofosmin, myocardial perfusion scintigraphy, reverse redistribution, washout, and washout rate. In the meta-analysis, a random-effects model was used to calculate the mean difference estimate. RESULTS: Forty articles were selected for systematic analysis: 13 were experimental, 24 were original clinical papers, 2 were clinical cases, and 1 was a review. Six studies using a case–control design were selected for the meta-analyses. The total number of patients in the systematic review and meta-analysis were 551 and 196, respectively. In the analysis of the literature, the severity of the reverse redistribution phenomenon and 99mTc-MIBI washout rate correlated with mitochondrial and myocardial microstructure, left ventricular contractility and hemodynamics, natriuretic peptide levels, exercise tolerance, coronary atherosclerosis severity, myocardial oxidative metabolism, and risk of cardiovascular events. The meta-analysis showed that the washout rate was statistically significantly accelerated in individuals with cardiac pathologies, relative to controls (mean difference score, 9.5771 [95%]; confidence interval, 6.6001–12.5540; z=6.3053, p 0.0001). CONCLUSION: The assessment of mitochondrial function by 99mTc-MIBI washout evaluation may provide additional insights into the functional status of cardiac muscles.
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Gulya et al. (2023) conducted a meta-analysis in Cardiac pathologies (n=196). Cardiac pathologies vs. Controls was evaluated on 99mTc-MIBI washout rate (MD 9.58, 95% CI 6.6001-12.5540, p=<0.0001). Cardiac pathologies were associated with a significantly accelerated 99mTc-MIBI washout rate compared to controls (MD 9.5771).
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