Gated SPECT in AMI patients with large perfusion defects and left ventricular dysfunction: comparison with two-dimensional echocardiography

초록

Purpose: We evaluated the accuracy of 99mTc-MIBI gated SPECT in assessing LV EF and volumes in patients with AMI, large perfusion defects and LV dysfunction. Methods: LV EF and volumes were determined by post-stress 99mTc-MIBI acquistition (≤4 days) in 16 patients with large perfusion defects (>20% of the LV) and LV dysfunction (EF<45% on echo) and in 14 patients without large perfusion defects by QGS software. All patients underwent Echo on admission. Results: No significant differences in LV volumes were observed between Echo and post-stress in patients with AMI, large perfusion defects and LV dysfunction (EDV; 161±44, ESV;100±38 vs EDV; 160±63, ESV; 107±60 ml), and without large perfusion defects (EDV;134±45, ESV; 65±23 vs. EDV; 115±39, ESV; 66±33 ml). No significant differences of EF were observed between echo (39±5%) and post-stress (37±13%) patients with large perfusion defects and LV dysfunction. Conversely, significant differences of EF were observed between echo (53±5%) and post-stress (44±8%) in patients without large perfusion defects (p<0.001). Conclusion: LV EF and volumes measurement is accurate using 99mTc-MIBI gated SPECT with QGS method in patients with AMI, large perfusion defects and LV dysfunction. However, 99mTc-MIBI gated SPECT significantly underestimated EF in patients with AMI, and without large perfusion defects.