Relation between perfusion defects on stress technetium-99m sestamibi SPECT scintigraphy and the location of a subsequent acute myocardial infarction

Gregory L. Miller, Steven D. Herman, Gary V. Heller, Sunil Kalla, William A. Levin, Kira M. Stillwell, Mark I. Travin

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Abstract

Although the presence of perfusion defects on stress myocardial perfusion imaging has been shown to correlate with future cardiac events, including acute myocardial infarction (AMI), it is unknown whether the location of the AMI can be predicted. Therefore, far 25 patients who had an AMI following a stress technetium-99m sestamibi single-photon emission computed tomographic (SPECT) imaging study and whose infarct location could be determined, the territory of infarction was correlated with the location of previous myocardial perfusion defects. A SPECT perfusion defect had been present in 24 patients (96%). The AMI occurred in territories that showed a reversible defect in 14 patients (56%), whereas 3 infarctions (12%) were in territories that revealed a fixed defect, and 8 infarctions (32%) were in territories that had not shown a defect on prior SPECT imaging. Whereas the incidence of infarction in territories with a reversible defect was highest at 14 of 26 (54%), the incidence of infarction in territories with a fixed defect was 3 of 7 (43%), and in territories with no defect was 8 of 42 (19%) (p = 0.011). Neither the time interval between SPECT imaging and infarction, nor the perfusion defect severity, was related to the correlation between perfusion defect and infarct location. Thus, although AMI occurs mast often at the site of previous perfusion defects, reversible or fixed, a substantial percentage occur in territories without a perfusion defect. These findings suggest that abnormalities on SPECT perfusion imaging, although they serve as markers of significant coronary disease and increase the likelihood of infarction, do not always predict the exact location of infarction.

Original languageEnglish (US)
Pages (from-to)26-30
Number of pages5
JournalAmerican Journal of Cardiology
Volume78
Issue number1
DOIs
StatePublished - Jul 1 1996
Externally publishedYes

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Emission-Computed Tomography
Technetium Tc 99m Sestamibi
Photons
Infarction
Perfusion
Myocardial Infarction
Myocardial Perfusion Imaging
Perfusion Imaging
Incidence
Coronary Disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Relation between perfusion defects on stress technetium-99m sestamibi SPECT scintigraphy and the location of a subsequent acute myocardial infarction. / Miller, Gregory L.; Herman, Steven D.; Heller, Gary V.; Kalla, Sunil; Levin, William A.; Stillwell, Kira M.; Travin, Mark I.

In: American Journal of Cardiology, Vol. 78, No. 1, 01.07.1996, p. 26-30.

Research output: Contribution to journalArticle

Miller, Gregory L. ; Herman, Steven D. ; Heller, Gary V. ; Kalla, Sunil ; Levin, William A. ; Stillwell, Kira M. ; Travin, Mark I. / Relation between perfusion defects on stress technetium-99m sestamibi SPECT scintigraphy and the location of a subsequent acute myocardial infarction. In: American Journal of Cardiology. 1996 ; Vol. 78, No. 1. pp. 26-30.
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