Detecting Myocardial Ischemia With 99mTechnetium-Tetrofosmin Myocardial Perfusion Imaging in Ischemic Stroke. (October 2017)

• Record Type: Journal Article
• Authors: Giannopoulos, Sotirios; Markoula, Sofia; Sioka, Chrissa; Zouroudi, Sofia; Spiliotopoulou, Maria; Naka, Katerina K.; Michalis, Lampros K.; Fotopoulos, Andreas; Kyritsis, Athanassios P.
• Is Part Of: Neurohospitalist. Volume 7:Number 4(2017:Oct.)
• Page Start: 164
• Page End: 168
• Publication Date: 2017-10
• Subjects: myocardial perfusion imaging -- MPI -- tetrofosmin -- SPECT -- ischemic stroke -- myocardial ischemia -- coronary artery disease; Nervous system -- Diseases -- Periodicals; Neurology -- Periodicals; 616.8
• DOI: 10.1177/1941874417704752
• Languages: English
• ISSNs: 1941-8744

Abstract

Background: To assess the myocardial status in patients with stroke, employing myocardial perfusion imaging (MPI) with 99m Technetium-tetrofosmin ( 99m Tc-TF)-single-photon emission computed tomography (SPECT). Methods: Fifty-two patients with ischemic stroke were subjected to 99m Tc-TF-SPECT MPI within 1 month after stroke occurrence. None of the patients had any history or symptoms of coronary artery disease or other heart disease. Myocardial perfusion imaging was evaluated visually using a 17-segment polar map. Myocardial ischemia (MIS) was defined as present when the summed stress score (SSS) was >4; MIS was defined as mild when SSS was 4 to 8, and moderate/severe with SSS ≥9. Patients with SSS >4 were compared to patients with SSS <4. Parameters such as age, body mass index, waist perimeter, smoking habits, and medical history (diabetes mellitus, dyslipidemia, etc) were evaluated according to MPI results. Results: Myocardial ischemia was present in 32 (62%) of 52 patients with stroke. Among them, 20 (62%) of 32 patients had mild abnormalities and 12 (38%) of 32 had moderate/severe. The age and waist perimeter showed a tendency to relate to severe MIS when patients with SSS >9 were compared to patients with SSS <4. In MPI-positive patients, an age was to be association with SSS, with the oldest age exhibiting the highest SSS ( P = .01). The association of age with SSS remained statistically significant in the multivariate analysis ( P = .04). Conclusion: The study suggested that more than half of patients with stroke without a history of cardiac disease have MIS. Although most of them have mild MIS, we suggest a thorough cardiological evaluation in this group of patients for future prevention of severe myocardial outcome.