Funktionelle/metabolische KHK-Diagnostik: Arbutamin-RNV, Streß-Echo, TI-SPECT und getriggerte FDG-PET

Zusammenfassung

Diese Kasuistik zeigt die synoptische Bedeutung der nuklearkardiologi-schen Methoden in der Beurteilung der myokardialen Perfusion sowie der Myokardvitalität am Beispiel eines 58jährigen Patienten mit koronarer Herzerkrankung vor geplanter Bypass-Operation.

Summary

In this report we discuss the abilities of intercorrelative cardiovascular nuclear medicine to detect and characterize myocardial perfusion anomalies and viable myocardium in an 58-year-old patient before revascularization.

Schlüsselwörter

Koronare Herzkrankheit (KHK) - hibernating myocardium - ²⁰¹TI-Myokard-SPECT - ¹⁸F-FDG-PET - Streß-Echokardiographie

Keywords

Coronary artery disease (CAD) - myocardial scintigraphy - gated FDG-PET - stress-echocardiography

• LITERATUR

• 1 Bing R. Cardiac metabolism. Physiol Rev 1965; 45: 171-213.
• 2 Bonow R, Dilsizian V, Cuocolo A, Bacharach S. Identification of viable myocardium in patients with chronic coronary artery disease and left ventricular dysfunction: comparison of thallium scintigraphy with reinjection and PET imaging with F-18-fluorodeoxyglucose. Circulation 1991; 83: 26-37.
• 3 Foreman R, Kirk ES. ²⁰¹Thallium accumulation during reperfusion of ischemic myocardium: dependence on regional flow rather than on viability. Amer J Cardiol 1984; 54: 659-63.
• 4 Gibbson RS, Watson DD, Taylor GJ. et al. Prospective assessment of regional myocardial perfusion before and after coronary revascularization surgery by quantitative thallium-201 scintigraphy. J Am Coll Cardiol 1993; 1: 804-15.
• 5 Hör G. What is the current status of quantification and nuclear medicine in cardiology?. Eur J Nucl Med 1996; 23: 815-51.
• 6 Hör G, Zöller A, Klepzig Jr H, Hartmann A, Maul FD, Hertel A. et al. Klinische Relevanz der Äquilibrium-Radionuklidventrikulogra-phie. Med Klinik 1994; 89: 442-52.
• 7 Liedtke AJ. Alterations of carbohydrate and lipid metabolism in the acutely ischemic heart. Prog Cardiovasc Dis 1981; 23: 321-36.
• 8 Liu P, Kiess MC, Okada RD. et al. The persistent defect on excercise thallium imaging and its fate after myocardial revascularization: does it represent scar or ischemia?. Am Heart J 1985; 110: 996-1001.
• 9 Ratib O, Phelps ME, Huang SC, Henze E, Selin CE, Schelbert HR. Positron tomography with deoxyglucose for estimating local myocardial glucose metabolism. J Nucl Med 1982; 23: 577-86.
• 10 Turner M, Vivian G, Marshall A. Arbutamine pharmacological stress: Myocardial perfusion scintigraphy (MPS) and ECG discordance. Nucl Med Com 1996; 6: 17.
• 11 Vogel RA. Imaging and echocardiography (editorial). Curr Opinion Cardiol 1990; 5: 781-2.