Area at risk can be assessed by iodine-123-meta-iodobenzylguanidine single-photon emission computed tomography after myocardial infarction: a prospective study. Issue 2 (February 2018)

• Record Type: Journal Article
• Authors: Hedon, Christophe; Huet, Fabien; Ben Bouallegue, Fayçal; Vernhet, Hélène; Macia, Jean-Christophe; Cung, Thien-Tri; Leclercq, Florence; Cade, Stéphane; Cransac, Frédéric; Lattuca, Benoit; Vandenberghe, D'Arcy; Bourdon, Aurélie; Benkiran, Meriem; Vauchot, Fabien; Gervasoni, Richard; D'estanque, Emmanuel; Mariano-Goulart, Denis; Roubille, François
• Is Part Of: Nuclear medicine communications. Volume 39:Issue 2(2018:Feb.)
• Publication Date: 2018-02
• Subjects: area at risk -- cardiac magnetic resonance -- 123I-MIBG SPECT -- myocardial infarction -- sympathetic denervation; Nuclear medicine -- Periodicals; 616.07575
• DOI: 10.1097/MNM.0000000000000782
• Languages: English
• ISSNs: 0143-3636

Abstract

Abstract : Background: Myocardial salvage is an important surrogate endpoint to estimate the impact of treatments in patients with ST-segment elevation myocardial infarction (STEMI). Aim: The aim of this study was to evaluate the correlation between cardiac sympathetic denervation area assessed by single-photon emission computed tomography (SPECT) using iodine-123-meta-iodobenzylguanidine ( 123 I-MIBG) and myocardial area at risk (AAR) assessed by cardiac magnetic resonance (CMR) (gold standard). Patients and methods: A total of 35 postprimary reperfusion STEMI patients were enrolled prospectively to undergo SPECT using 123 I-MIBG (evaluates cardiac sympathetic denervation) and thallium-201 (evaluates myocardial necrosis), and to undergo CMR imaging using T2-weighted spin-echo turbo inversion recovery for AAR and postgadolinium T1-weighted phase sensitive inversion recovery for scar assessment. Results: 123 I-MIBG imaging showed a wider denervated area (51.1±16.0% of left ventricular area) in comparison with the necrosis area on thallium-201 imaging (16.1±14.4% of left ventricular area, P <0.0001). CMR and SPECT provided similar evaluation of the transmural necrosis ( P =0.10) with a good correlation ( R =0.86, P <0.0001). AAR on CMR was not different compared with the denervated area ( P =0.23) and was adequately correlated ( R =0.56, P =0.0002). Myocardial salvage evaluated by SPECT imaging (mismatch denervated but viable myocardium) was significantly higher than by CMR ( P =0.02). Conclusion: In patients with STEMI, 123 I-MIBG SPECT, assessing cardiac sympathetic denervation may precisely evaluate the AAR, providing an alternative to CMR for AAR assessment. Abstract : Supplemental Digital Content is available in the text.