Left ventricular volumes, ejection fraction, and regional wall motion calculated with gated technetium-99m tetrofosmin SPECT in reperfused acute myocardial infarction at super-acute phase: comparison with left ventriculography

Abstract

Background: Noninvasive assessment of acute myocardial infarction (AMI) requires information about both myocardial perfusion and left ventricular (LV) function. The automated quantification of electrocardiographic-gated myocardial scintigraphy with technetium-99m tetrofosmin (QGS) can provide this information.

Methods and results: Coronary arteriography, QGS, and left ventriculography (LVG) were performed in 229 patients with reperfused AMI within 2 days after onset. All infarcted vascular territories (229 segments) were visualized with scintigraphic perfusion images. The mean wall motion score (WMS) was 15.9+/-2.8 by means of QGS and 16.3+/-2.9 by means of LVG. The correlation between WMS obtained by means of QGS and that obtained by means of LVG was close (y = 0.913x + 1.016, r = 0.94, P<.001), but that obtained by means of QGS was significantly lower than that obtained by means of LVG (P<.0001). Total agreement for the assessment of regional wall motion reached 75 % (kappa, 0.66). Although the LV values obtained by means of QGS and LVG correlated well (end-diastolic volume, r = 0.67, P<.0001; end-systolic volume, r = 0.79, P<.0001; ejection fraction, r = 0.78, P<.0001), end-diastolic volume and ejection fraction tended to be underestimated with QGS.

Conclusion: QGS data were considered to be useful in detecting infarcted vascular territory and LV function, even in AMI, within 2 days after onset.