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. (J Nucl Cardiol 2000;7:569-74.)