Technetium-99m teboroxime regional myocardial washout in subjects with and without coronary artery disease

Am J Cardiol. 1993 Sep 15;72(9):728-34. doi: 10.1016/0002-9149(93)90893-h.

Abstract

The aim of this study was to test the hypothesis that regional myocardial washout of technetium-99m teboroxime is slowed in the presence of coronary stenosis. Washout was assessed in 33 catheterized patients and in 13 with a low likelihood of coronary artery disease, using a triple detector camera and dynamic single-photon emission computed tomography, with serial 1-minute acquisitions after injection of 20 to 25 mCi of teboroxime at the third minute of adenosine-induced hyperemia. Washout was measured as the percent change in counts between the first, second and third minutes after injection, as measured in 6 short-axis myocardial regions of interest. Myocardial regions were classified as ischemic (> or = 50% diameter stenosis and no prior myocardial infarct), infarcted, normal (no significant coronary stenosis) or "low likelihood" (from the 13 patients with a low likelihood of coronary artery disease). Teboroxime washout was significantly (p < 0.001) slowed in the ischemic myocardium (12.7 +/- 8.3%) compared with the normal (18.5 +/- 5.7%), low-likelihood (17.8 +/- 6.1%) and infarcted (17.8 +/- 4.4%) zones. There was regional variability in washout rates (% washout/min), with the anterior wall having the lowest (13.8 +/- 3.4%/min) and the inferior wall the highest (20.7 +/- 7.9%/min) values. In regard to individual coronary territories, 21 of 41 ischemic, noninfarcted territories (51%) had abnormal washout compared with 3 of 43 normal territories (7%) (p = 0.001). In conclusion, regional washout of teboroxime is detectably slowed in ischemic, noninfarcted myocardium. The clinical value of washout analysis in teboroxime single-photon emission computed tomography warrants further investigation.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cohort Studies
  • Coronary Angiography
  • Coronary Disease / diagnostic imaging
  • Coronary Disease / metabolism
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / metabolism
  • Diffusion
  • Heart / diagnostic imaging
  • Humans
  • Image Processing, Computer-Assisted
  • Myocardial Infarction / diagnostic imaging
  • Myocardial Infarction / metabolism*
  • Myocardial Ischemia / diagnostic imaging
  • Myocardial Ischemia / metabolism*
  • Myocardium / metabolism*
  • Organotechnetium Compounds / pharmacokinetics*
  • Oximes / pharmacokinetics*
  • Sensitivity and Specificity
  • Time Factors
  • Tomography, Emission-Computed, Single-Photon*

Substances

  • Organotechnetium Compounds
  • Oximes
  • technetium Tc 99m teboroxime