Comparative Study On Detection Of Viabile Myocardium Between Treadmill Exercise Test And ^99mTc-MIBI/¹⁸F-FDG Dual Isotope Simultaneous Acquisition Of SPECT

Objective:The objective of this study is to investigate the feasibility sensitivity,specificity, accuracy of treadmill exercise test technology for the detection of myocardial viability in old myocardial infarction,use ^99mTc-MIBI/¹⁸F-FDG dual isotope simultaneous acquisition of single photon emission computed tomography(SPECT)as a reference.Methods:15 consecutive patients(13 males,2 females,mean age 55±8years)were evaluated.All patients underwent coronary arteriography,maximal treadmill exercise testing and ^99mTc-MIBI/ ¹⁸F-FDG dual isotope simultaneous acquisition of SPECT.All patients of the ^99mTc-MIBI/ ¹⁸F-FDG dual isotope simultaneous acquisition of SPECT was assessed to divide the subjects into two groups according to it,so myocardial viability group and non myocardial viability group.The optimal index in treadmill exercise testing from ST segment elevation,ST segment elevation and ST segment depression,Q-wave prolongation,QRS-wave prolongation,R-wave amplitude of vibration upgrade and QT dispersion was chosen and then the sensitivity,specificity and accuracy were calculated for identifying myocardial viability and analysis correlation of ^99mTc-MIBI/ ¹⁸F-FDG dual isotope simultaneous acquisition of SPECT.Results:There was 7 pou Q-wave prolongation in myocardial viability group(8 pou,n=8), and 1 pou Q-wave prolongation in non myocardial viability group(7 pou,n=7);there was 4 pou ST segment elevation in myocardial viability group,and 4 pou ST segment elevation in non myocardial viability group;there was 3 pou ST segment elevation and ST segment depression in myocardial viability group,and 1 pou ST segment elevation and ST segment depression in non myocardial viability group;there was 3 pou R-wave amplitude of vibration upgrade in myocardial viability group,and 4 pou R-wave amplitude of vibration upgrade in non myocardial viability group;there was 2 pou QRS-wave prolongation in myocardial viability group,and 2 pou QRS-wave prolongation in non myocardial viability group;there was 6 pou QT dispersion≤70ms in myocardial viability group,and 2 pou QT dispersion≤70ms in non myocardial viability group.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value to evaluating myocardial viability of Q-wave prolongation was 87.5%,85.6%,86.7%,87.5%,85.6%;The sensitivity,specificity,accuracy, positive predictive value,negative predictive value to evaluating myocardial viability of ST segment elevation was 50.0%,42.9%,46.7%,50.0%,42.9%;The sensitivity,specificity, accuracy,positive predictive value,negative predictive value to evaluating myocardial viability of ST segment elevation and ST segment depression was 37.5%,85.6%,60.0%,75.0%,54.5%; The sensitivity,specificity,accuracy,positive predictive value,negative predictive value to evaluating myocardial viability of R-wave amplitude of vibration upgrade was 37.5%,42.9%,40.0%,42.9%,37.5%;The sensitivity,specificity,ccuracy,positive predictive value,negative predictive value to evaluating myocardial viability of QRS-wave prolongation was 25.0%,71.4%,40.6%,50.0%,45.5%;The sensitivity,specificity,accuracy,positive predictive value,negative predictive value to evaluating myocardial viability of QT dispersion≤70ms was 75.0%,71.4%,73.3%,75.0%,71.4%.In all index,the sensitivity,specificity, accuracy,positive predictive value,negative predictive value of Q-wave prolongation and QT dispersion≤70ms had greater high to the other index.In Chi- square test,Q-wave prolongationdetected myocardial viability has well consistency with the ^99mTc-MIBI/¹⁸F-FDG dual isotope simultaneous acquisition of SPECT,and greater statistical differences of two (P=0.009).Q-wave prolongation can as a superiority screening index to generalize to detection of myocardial viability in post-infarction patients.Conelution:1.Treadmill exercise test technology can able to quantify myocardial viablity,and Q-wave prolongation and QT dispersion≤70ms are the sensitive index of treadmill exercise test. 2.The duration of the infarct-related Q-wave is significantly increased during treadmill exercise testing in those patients with single-vessel coronary artery disease and a recent previous myocardial infarction who certificated by ^99mTc-MIBI/ ¹⁸F-FDG dual isotope simultaneous acquisition of SPECT.The sensitivity,specificity to evaluating myocardial viability of has higher value.Exercise-induced Q-wave prolongation was found to be a sensitive and sp.ecific ECG marker for the detection of myocardial viability in the infarcted area.This finding may render exercise electrocardiography a simple,widely available,and low-cost method for the detection of myocardial viability in post-infarction patients.3.In some old myocardial patients,there have very number viabile myocardium in infarcted region.According to detecting viabile myocardium,we can perfoms more reasonable clinical instruments to save this myocardial viability.