ADENOSINE TC-99M SESTAMIBI (SPECT) FOR THE EARLY ASSESSMENT OF JEOPARDIZED MYOCARDIUM AFTER ACUTE MYOCARDIAL-INFARCTION

The purpose of this study was to evaluate the accuracy of adenosine Tc -99m sestamibi single photon emission computed tomography (SPECT) in t he detection of jeopardized myocardium early after acute myocardial in farction. Coronary arteriography and myocardial scintigraphy were perf ormed in 50 consecutive patients with an uncomplicated myocardial infa rction. Myocardium was considered jeopardized if a significant infarct -related vessel stenosis (> 50% diameter stenosis) supplied an infarct area with residual viable tissue. Perfusion reversibility in the infa rct region occurred in 25 patients (50%) and was almost solely observe d in the presence of jeopardized myocardium. Non-reversible perfusion defects in the infarct region were found in patients without jeopardiz ed myocardium. This subgroup consisted of either patients without sign ificant vessel stenosis or patients without significant residual viabi lity in the infarct region. Adenosine Tc-99m sestamibi SPECT had an ac curacy of 88% for the detection of jeopardized myocardium. Side effect s during adenosine infusion were frequently observed but well tolerate d. These results suggest that adenosine Tc-99m sestamibi SPECT is an a ccurate non-invasive method for detecting jeopardizing myocardium afte r acute myocardial infarction and may be a valuable non-invasive test for the early selection of patients at risk for future ischaemic event s.