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首页> 外文期刊>Indian Journal of Nuclear Medicine >Role of myocardial perfusion scintigraphy post invasive coronary angiography in patients with Myocardial Infarction
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Role of myocardial perfusion scintigraphy post invasive coronary angiography in patients with Myocardial Infarction

机译：冠状动脉造影后心肌灌注显像在心肌梗死患者中的作用

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Background:The presence of severe hypokinesia or akinesia and near complete stenotic lesions on coronary angiography, in a patient with acute myocardial infarction raises a question of viability in the involved territory and its response to revascularization. The decision of revascularization can be effectively taken after myocardial perfusion scintigraphy (MPS).Aim:To evaluate the role of MPS in patients with acute or recent myocardial infarction after invasive coronary angiography.Materials and Methods:Thirty-five patients (27 Males, 8 Females; Mean age 54 years) with acute myocardial infarction, who underwent invasive angiography, were included prospectively. Invasive angiography was attempted during the episode of acute chest pain in 20 patients. Fifteen patients underwent angiography without MPS because of non-availability of MPS at the time of initial presentation in the referring hospital. Revascularization was deferred because of complete / near complete block of artery with hypokinesia / akinesia of the distal LV segments in 32 / 35 patients and 50 to 70% block in 3 / 35. These patients were subjected to MPS.Results:Twenty patients underwent stress MPS and 15 underwent nitrate-augmented rest re-distribution study (RR study). Imaging was performed using the hybrid SPECT / CT system. The average defect size of the perfusion defect was 34% (5 - 57% range). Sixteen patients (46%) had fixed perfusion defects. Reversible ischemia was present in 19 (54%). Ten patients had a 10% of the LV myocardium, and underwent the invasive revascularization procedure.Conclusion:MPS is invaluable in patients who have total / near total occlusion of the coronary artery and distal segment hypokinesia or akinesia on invasive angiography. One in four patients, deemed to have non-viable myocardium, underwent an invasive revascularization after undergoing MPS.
机译：背景：在急性心肌梗死患者中，严重的运动功能减退或运动障碍以及在冠状动脉造影上接近完全狭窄的病变的存在提出了在受累区域的生存能力及其对血运重建的反应的问题。心肌灌注显像（MPS）后可以有效地决定血运重建的目的。目的：评估MPS在有创冠状动脉造影后急性或近期心肌梗死患者中的作用。材料与方法：35例（27例男性，8例）前瞻性纳入接受侵入性血管造影的急性心肌梗死女性（平均年龄54岁）。在20例急性胸痛发作期间尝试了有创血管造影。由于在转诊医院初次就诊时没有MPS，因此有15例患者接受了无MPS的血管造影检查。由于32/35例患者的运动完全/近端LV段运动不全/运动障碍和3/35例中的50％至70％的动脉完全/接近完全阻塞而导致血运重建推迟。结果：20例患者承受了压力MPS和15进行了硝酸盐增强的休息再分布研究（RR研究）。使用混合SPECT / CT系统进行成像。灌注缺陷的平均缺陷大小为34％（5-57％范围）。 16名患者（46％）患有固定的灌注缺陷。 19％（54％）存在可逆性缺血。 10例患者的LV心肌占10％，并进行了有创血运重建。结论：MPS对于完全/接近完全阻塞性冠状动脉闭塞和远端段运动功能减退或运动障碍的患者具有重要价值。四分之一的患者被认为患有无法存活的心肌，在接受MPS后进行了侵入性血运重建。

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