Relationship Between the Location of the Most Severe Myocardial Perfusion Defects, the Most Severe Coronary Artery Stenosis, and the Site of Subsequent Myocardial Infarction

Journal of Nuclear Medicine

Marc Simó¹  Jordi Soler-Soler¹  César Santana-Boado¹  Guillermo Oller-Martínez¹  Santiago Aguadé-Bruix¹  Mario Missorici¹  María J. Díez-Castro¹  Joan Castell-Conesa¹  Jaume Candell-Riera¹  Osvaldo Pereztol-Valdés¹ 

[1] Hospital Universitari Vall d’Hebron, Barcelona, Spain Hospital Universitari Vall d’Hebron, Barcelona, Spain Hospital Universitari Vall d’Hebron, Barcelona, Spain

关键词: acute myocardial infarction;    coronary angiography;    coronary artery disease;    SPECT;   

DOI  :  

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

This study evaluated the relationship between the location of the most severe myocardial perfusion defects, the most severe coronary artery stenosis, and the site of subsequent acute myocardial infarction (AMI). Methods: Of 3,180 patients who were admitted with a diagnosis of AMI, we identified 44 patients who had undergone previous myocardial perfusion SPECT. Thirty-one of them also had previous coronary angiography. The relationship between the location of the myocardial perfusion defects, the coronary artery stenosis, and the site of subsequent AMI was studied in these patients. Results: The concordance between the location of the most severe reversible defects detected by SPECT and the site of subsequent AMI was 71% (κ = 0.499). The concordance between the most severe stenosis detected by coronary angiography and the site of subsequent AMI was 64% (κ = 0.451). However, κ values for SPECT and coronary angiography were good when the interval between these investigations and subsequent AMI was <3 mo (0.724 and 0.661, respectively), for moderate to severe perfusion defects (0.719), and for 90%–99% coronary stenosis (0.626). Conclusion: The culprit lesion is not always the one that is manifested by the most severe reversible perfusion defect or the most critical coronary artery stenosis. Myocardial SPECT and coronary angiography can predict the location of a future AMI in 71% and 64% of patients, respectively. The percentage is higher when the interval between investigations and subsequent AMI is <3 mo, for moderate to severe perfusion defects, and for 90%–99% coronary stenosis.

【 授权许可】

Unknown