Adenosine Technetium-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 adenosineTc-99m sestamibi single photon emission computed tomography(SPECT) in the detection of jeoparidized myocardium early afteracute myocardial infarction. Coronary arteriography and myocardialscintigraphy were performed in 50 consecutive patients withan uncomplicated myocardial infarction. Myocardium was consideredjeopardized if a significant infarct-related vessel stenosis(> 50% diameter stenosis) supplied an infarct area with residualviable tissue. Perfusion reversibility in the infarct regionoccurred in 25 patients (50%) and was almost solely observedin the presence of jeopardized myocardium. Non-reversible perfusion defects in the infarct region werefound in patients without jeopardized myocardium. This subgroupconsisted of either patients without significant vessel stenosisor patients without significant residual viability in the infarctregion. Adenosine Tc-99m sestamibi SPECT had an accuracy of88% for the detection of jeopardized myocardium. Side effectsduring adenosine infusion were frequently observed but welltolerated. These results suggest that adenosine Tc-99m sestamibi SPECTis an accurate non-invasive method for detecting jeopardizedmyocardium after acute myocardial infarction and may be a valuablenon-invasive test for the early selection of patients at riskfor future ischaemic events.