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OBJECTIVE TI-201 myocardial perfusion SPECT is commonly used to assess myocardial perfusion and viability. Nitrate-augmented redistribution with repeated injection facilitates the detection of reversible segments compared with standard redistribution. In this study, we investigated the potential of nitrate augmentation to improve myocardial perfusion and viability assessment without repeated injection and we also compared nitrate-augmented redistribution with delayed redistribution. METHODS Eighteen patients underwent a stress-redistribution TI-201 SPECT study. Immediately after redistribution SPECT, each patient was administered 0.6 mg glyceryl trinitrate and nitrate-augmented redistribution SPECT acquired 30 minutes later. Each patient then returned the next day and was injected with a booster dose of TI-201 30 minutes before the delayed redistribution SPECT acquisition. For each SPECT study, the myocardium was divided into 11 segments, and perfusion to each segment was scored on a four-point scale by consensus. An overall cardiac perfusion score was derived by summing the perfusion score for each segment. RESULTS Reduced stress perfusion was identified in 150 segments: 23 (15.3%) had improved perfusion after redistribution; 60 (40%) segments had improved perfusion after nitrate-augmented redistribution; 52 (34.7%) segments with reduced stress perfusion had improved perfusion after delayed redistribution. The cardiac perfusion score after stress was 15.9+/-5.5 (means+/-SD). The score increased to 17.4+/-5.4 after redistribution. The perfusion score improved to 19.7+/-5.8 (P < 0.05 versus redistribution) after nitrate augmentation. The cardiac perfusion score, 19.2+/-6.4, did not improve further after delayed redistribution. CONCLUSIONS TI-201 SPECT with nitrate-augmented redistribution is as good or better than delayed redistribution with repeated injection for myocardial perfusion and viability assessment. TI-201 SPECT with nitrate-augmented redistribution has significant logistical and economic advantages over traditional delayed redistribution with TI-201 repeated injection.
S S Wadhwa, and
R Mansberg, and
V B Fernandes
November 1989,
Chest,
S S Wadhwa, and
R Mansberg, and
V B Fernandes
June 2005,
Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology,
S S Wadhwa, and
R Mansberg, and
V B Fernandes
January 2002,
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology,
S S Wadhwa, and
R Mansberg, and
V B Fernandes
January 2004,
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology,
S S Wadhwa, and
R Mansberg, and
V B Fernandes
January 2001,
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology,
S S Wadhwa, and
R Mansberg, and
V B Fernandes
December 1991,
Kaku igaku. The Japanese journal of nuclear medicine,
S S Wadhwa, and
R Mansberg, and
V B Fernandes
November 1994,
Clinical nuclear medicine,
S S Wadhwa, and
R Mansberg, and
V B Fernandes
January 1991,
Scandinavian journal of thoracic and cardiovascular surgery,
S S Wadhwa, and
R Mansberg, and
V B Fernandes
May 2024,
Clinical nuclear medicine,
S S Wadhwa, and
R Mansberg, and
V B Fernandes
January 1997,
Anticancer research,
