DIAGNOSTIC VALUE of Tc-99m TETROFOSMİN GATED SPECT IN MYOCARDIAL VIABILITY INVESTIGATION AFTER ADMINISTRATION TRIMETAZIDINE and NITRATE IN THE PATIENTS WITH MYOCARDIAL INFARCTION

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TURHAL, Özgül ; TUTUŞ, Ahmet ; KULA, Mustafa (2019)
  • Publisher: Kayseri EAH
  • Journal: (issn: 2587-1153, eissn: 2587-1153)
  • Subject: Myocardial scintigraphy,viability,trimetazidine | Miyokard sintigrafisi,canlı doku,trimetazidin

ABSTRACT Aim: With the aim of investigating of the myocardial viability on the patients with MI, the results obtained from Tc-99m-tetrofosmin gated SPECT following the nitrate infusion and acute TMZ were compared.Method: For this study, 30 patients who had MI and were be planned of revascularization process were taken. The patients were applied Tc-99m-tetrofosmin gated SPECT basally and following nitrate infusion and acute TMZ separately each day. The data from perfusion were quantitatively evaluated whilst wall motion images were visually scored. The segments having more than 55% of maximum activity and moving normally or being hypo-kinetic were concluded as viable. The data obtained were statistically evaluated by “t” and “chi-square” tests.Results: While the 41 segments (19.9%) of non-viable 206 segments from the basal study were considered as viable after nitrate study, 42 segments (20%) were considered as viable after TMZ study. While the wall motions of 117 segments improved in the nitrate study, wall-motions of 43 segments improved in the TMZ study. Although there were more significant increases (36.5% ± 11.3, 42.1% + 12.7, p<0.05) in the post-nitrate left ventricule EFs than basal study, no significant changes (36.5% ± 11.3, 38.3% ± 10.9, p>0.05) occurred in the TMZ study. Moreover, while the blood pressures of the patients decreased after nitrate, the hemodynamic parameters of patients did not change significantly after acute TMZ.Conclusion: The concordance of perfusion images from TMZ and nitrate studies in determining the myocardial viability was calculated as 87%. In the evaluation of HM, nitrate infusion was found better since both the number of segments whose wall-motions improved and the mean activity uptake ratios of all segments were many more than the results of TMZ studies. However, it was concluded that post-TMZ Tc-99m-tetrofosmin imaging can be especially useful for the patients whose hemodynamic parameters are not well. 
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