IDENTIFICATION HIBERNATING MYOCARDIUM WIT H RESTING 99M-TC SESTAMIBI SCINTIGRAPHY

The aim of this study was to assess the value of resting 99m Tc-Sestam ibi scintigraphy for the detection of hibernating myocardium in zones of contractile dysfunction. Based on a series of 25 patients, 27 segme nts of supposedly hibernating myocardium were identified. All these se gments corresponded to left ventricular wall motion abnormalities conf irmed by contrast angiography and were perfused by a stenosed coronary artery : none of these zones were infarcted. Before revascularisation , comparison of the results of ventriculography and scintigraphy showe d a correlation (p < 0.001) between the severity of regional contracti le dysfunction appreciated by the center line method and the degree of myocardial hypofixation of 99m Tc MIBI. Three months after revascular isation, improvement of regional wall motion, assessed by control cont rast angiography, was observed in 21 of the 27 segments studied (78 %) . Of these 21 segments, the viability of which was confirmed, 13 had a non-transmural uptake defect and 8 were normal on pre-revascularisati on scintigraphy. The 6 segments without improvement at the 3 month con trol, had a transmural uptake defect on scintigraphy in 67 % of cases. The authors concluded that when a residual uptake defect of 99m Tc se stamibi is present, viable myocardium may also be present.