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Comparison of Nitrate Augmented 99mTc-Sestamibi Infusion with Nitrate Augmented 99mTc-Sestamibi Bolus Injection for the Detection of Myocardial Viability
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This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher.
Abstract
Aim:
It has been stated that nitrate augmented 99mTc-Sestamibi bolus injection is almost comparable to 24-hour reinjection of Tl-201 for the detection of myocardial viability. This study was aimed to see if nitrateaugmented infusion injection of 99mTc-Sestamibi can reveal more areas of viable myocardium as compared to the standard stress rest protocol of 99mTc-Sestamibi and nitrate-augmentation.
Materials & Methods:
25 patients (all men) with a mean age of 42.72 yrs (age ranging from 28-57 yrs) with a recent history of myocardial infarction (3 weeks to 6 months) were included in the study. A routine stress — rest myocardial perfusion scan with 99mTc-Sestamibi was performed on these subjects. The rest study was augmented with 10 mg of nitroglycerin sublingually. These subjects were given the same dose of nitroglycerin and 99mTc-Sestamibi two days later. 99mTc-Sestamibi was given as an infusion over a period of 45 minutes and images were obtained after one hour. 17 segment myocardial model was taken for analysis and a total of 425 segments were analyzed out of which 176 segments were for viability evaluation. Results: In resting images obtained with MIBI bolus injection, there was improvement in 17 segments (9.6%) when compared to the post stress images and in images obtained after infusion, there was improvement in 34 assessed for viability segments (19.3%). In the remaining segments, there was improvement in 48 segments (19.27%) in the images obtained with MIBI bolus injection and improvement in 85 segments (34.13%) in the images obtained with MIBI infusion.
Conclusion:
This study shows that nitrate augmented MIBI infusion is helpful in detecting more areas of viable myocardium when compared to the standard resting study following bolus injection.
