ASSESSING MYOCARDIAL VIABILITY - CORRELATION OF MYOCARDIAL WALL-MOTION ABNORMALITIES AND PATHOLOGICAL Q-WAVES WITH TECHNETIUM 99M SESTAMIBISINGLE-PHOTON EMISSION COMPUTED-TOMOGRAPHY

The clinical benefit of coronary revascularization depends largely on the viability of the myocardium that is perfused. To determine if the combination of electrocardiogram and left ventriculography findings co uld be used to predict viability, the presence of pathologic Q waves a nd wall motion abnormalities on contrast left ventriculography were co rrelated with findings on stress sestamibi scanning in 201 patients. W all motion was abnormal in 51.5% of 103 Q regions; 30 (56.6%) of these had fixed sestamibi defects, and 22.6% had fully or partially reversi ble sestamibi defects. Q waves were associated with 43.4% of 122 regio ns with wall motion abnormality; 67.9% of these areas had fixed or par tially fixed sestamibi defects. Wall motion abnormalities were present in 46.1% of 104 areas with fixed sestamibi defects. Although there wa s a statistically significant correlation among Q waves, left ventricu lar wall motion abnormalities, and stress sestamibi uptake (and variou s combinations of these data), the relatively large number (53.8%) of discordant findings (e.g., normal ventricular wall motion in the prese nce of tired sestamibi defects) suggests that nonviability cannot be a ssumed without at least assessing both contractile left ventricular mo tion and metabolic (e.g., sestimibi scanning) function.