Magnetic resonance vs technetium-99m pyrophosphate scintigraphy in the detection of perioperative myocardial necrosis
Perioperative myocardial infarction (POMI) is a complication of coronary artery bypass grafting (CABG) with a potential prognostic impact. Technetium-99m pyrophosphate myocardial scintigraphy (MS) is used in the diagnosis of POMI; however it shows a limited sensitivity for subendocardial lesions. Ca...
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| Veröffentlicht in: | Arquivos brasileiros de cardiologia 2008-08, Vol.91 (2), p.113-118 |
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| creator | Monte, Guilherme Urpia Drager, Luciano Ferreira Souza, Fábio Solano de Freitas Avila, Luiz Francisco Rodrigues de Parga Filho, José Rodrigues César, Luiz Antônio Machado Izaki, Marisa Meneghetti, José Cláudio Rochitte, Carlos Eduardo Kalil Filho, Roberto |
| description | Perioperative myocardial infarction (POMI) is a complication of coronary artery bypass grafting (CABG) with a potential prognostic impact. Technetium-99m pyrophosphate myocardial scintigraphy (MS) is used in the diagnosis of POMI; however it shows a limited sensitivity for subendocardial lesions. Cardiovascular magnetic resonance imaging (CMRI), in turn, has a high accuracy in the detection of myocardial necrosis.
To compare CMRI and MS for the detection of POMI after CABG.
A total of 24 patients with chronic coronary artery disease were studied using the delayed contrast enhanced CMRI and MS before and after CABG by analyzing the development of areas of perioperative myocardial necrosis (POMI). Biochemical markers of myocardial injury (CKMB and troponin I) were also determined before and after surgery.
Nineteen patients completed the study. Of these, 6 (32%) presented POMI on CMRI and 4 (21%) on MS (p = NS). Of the 323 left ventricular segments assessed, 17 (5.3%) showed perioperative necrosis on CMRI and 7 (2.2%) on MS (p = 0.013). Moderate agreement was observed between the methods (kappa = 0.46). There was disagreement regarding the diagnosis of POMI in 4 (21%) cases, most of them with small areas of perioperative necrosis on CMRI which were not visualized on MS. In all cases with POMI on CMRI, significant CKMB and troponin I elevations were observed.
Moderate diagnostic agreement was observed between the methods for the detection of POMI, but CMRI enabled visualization of small areas of perioperative myocardial necrosis which were not identified on MS and were associated with elevation of biochemical markers of myocardial injury. |
| doi_str_mv | 10.1590/S0066-782X2008001400009 |
| format | Article |
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To compare CMRI and MS for the detection of POMI after CABG.
A total of 24 patients with chronic coronary artery disease were studied using the delayed contrast enhanced CMRI and MS before and after CABG by analyzing the development of areas of perioperative myocardial necrosis (POMI). Biochemical markers of myocardial injury (CKMB and troponin I) were also determined before and after surgery.
Nineteen patients completed the study. Of these, 6 (32%) presented POMI on CMRI and 4 (21%) on MS (p = NS). Of the 323 left ventricular segments assessed, 17 (5.3%) showed perioperative necrosis on CMRI and 7 (2.2%) on MS (p = 0.013). Moderate agreement was observed between the methods (kappa = 0.46). There was disagreement regarding the diagnosis of POMI in 4 (21%) cases, most of them with small areas of perioperative necrosis on CMRI which were not visualized on MS. In all cases with POMI on CMRI, significant CKMB and troponin I elevations were observed.
Moderate diagnostic agreement was observed between the methods for the detection of POMI, but CMRI enabled visualization of small areas of perioperative myocardial necrosis which were not identified on MS and were associated with elevation of biochemical markers of myocardial injury.</description><identifier>EISSN: 1678-4170</identifier><identifier>DOI: 10.1590/S0066-782X2008001400009</identifier><identifier>PMID: 18709263</identifier><language>eng ; por</language><publisher>Brazil</publisher><subject>Biomarkers - blood ; Chronic Disease ; Coronary Disease - blood ; Coronary Disease - surgery ; Creatine Kinase, MB Form - blood ; Female ; Humans ; Intraoperative Complications ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Myocardial Infarction - diagnostic imaging ; Myocardial Infarction - pathology ; Myocardial Revascularization ; Necrosis ; Radionuclide Imaging ; Radiopharmaceuticals ; Sensitivity and Specificity ; Technetium Tc 99m Pyrophosphate ; Troponin I - blood</subject><ispartof>Arquivos brasileiros de cardiologia, 2008-08, Vol.91 (2), p.113-118</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,860,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18709263$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Monte, Guilherme Urpia</creatorcontrib><creatorcontrib>Drager, Luciano Ferreira</creatorcontrib><creatorcontrib>Souza, Fábio Solano de Freitas</creatorcontrib><creatorcontrib>Avila, Luiz Francisco Rodrigues de</creatorcontrib><creatorcontrib>Parga Filho, José Rodrigues</creatorcontrib><creatorcontrib>César, Luiz Antônio Machado</creatorcontrib><creatorcontrib>Izaki, Marisa</creatorcontrib><creatorcontrib>Meneghetti, José Cláudio</creatorcontrib><creatorcontrib>Rochitte, Carlos Eduardo</creatorcontrib><creatorcontrib>Kalil Filho, Roberto</creatorcontrib><title>Magnetic resonance vs technetium-99m pyrophosphate scintigraphy in the detection of perioperative myocardial necrosis</title><title>Arquivos brasileiros de cardiologia</title><addtitle>Arq Bras Cardiol</addtitle><description>Perioperative myocardial infarction (POMI) is a complication of coronary artery bypass grafting (CABG) with a potential prognostic impact. Technetium-99m pyrophosphate myocardial scintigraphy (MS) is used in the diagnosis of POMI; however it shows a limited sensitivity for subendocardial lesions. Cardiovascular magnetic resonance imaging (CMRI), in turn, has a high accuracy in the detection of myocardial necrosis.
To compare CMRI and MS for the detection of POMI after CABG.
A total of 24 patients with chronic coronary artery disease were studied using the delayed contrast enhanced CMRI and MS before and after CABG by analyzing the development of areas of perioperative myocardial necrosis (POMI). Biochemical markers of myocardial injury (CKMB and troponin I) were also determined before and after surgery.
Nineteen patients completed the study. Of these, 6 (32%) presented POMI on CMRI and 4 (21%) on MS (p = NS). Of the 323 left ventricular segments assessed, 17 (5.3%) showed perioperative necrosis on CMRI and 7 (2.2%) on MS (p = 0.013). Moderate agreement was observed between the methods (kappa = 0.46). There was disagreement regarding the diagnosis of POMI in 4 (21%) cases, most of them with small areas of perioperative necrosis on CMRI which were not visualized on MS. In all cases with POMI on CMRI, significant CKMB and troponin I elevations were observed.
Moderate diagnostic agreement was observed between the methods for the detection of POMI, but CMRI enabled visualization of small areas of perioperative myocardial necrosis which were not identified on MS and were associated with elevation of biochemical markers of myocardial injury.</description><subject>Biomarkers - blood</subject><subject>Chronic Disease</subject><subject>Coronary Disease - blood</subject><subject>Coronary Disease - surgery</subject><subject>Creatine Kinase, MB Form - blood</subject><subject>Female</subject><subject>Humans</subject><subject>Intraoperative Complications</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - diagnostic imaging</subject><subject>Myocardial Infarction - pathology</subject><subject>Myocardial Revascularization</subject><subject>Necrosis</subject><subject>Radionuclide Imaging</subject><subject>Radiopharmaceuticals</subject><subject>Sensitivity and Specificity</subject><subject>Technetium Tc 99m Pyrophosphate</subject><subject>Troponin I - blood</subject><issn>1678-4170</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1UM1KxDAYDIK46-oraE7eql_SpkmPsvgHigcVvJVs-nUb2TYxSRf69lZc5zADw8wchpBLBtdMVHDzBlCWmVT8kwMoAFbAjOqILFkpVVYwCQtyGuMXAOcyFydkwZSEipf5kowvejtgsoYGjG7Qg0G6jzSh6X7tsc-qqqd-Cs53LvpOJ6TR2CHZbdC-m6gdaOqQNjhXknUDdS31GKybSSe7R9pPzujQWL2jA5rgoo1n5LjVu4jnB12Rj_u79_Vj9vz68LS-fc48UyplWHHIpda8ADQAbS7aTamMlqZkDBspmcSG8ULzFkuRCyGUUHzTiqYRc7PIV-Tqb9cH9z1iTHVvo8HdTg_oxliXVZGLios5eHEIjpsem9oH2-sw1f9H5T-wz2zC</recordid><startdate>200808</startdate><enddate>200808</enddate><creator>Monte, Guilherme Urpia</creator><creator>Drager, Luciano Ferreira</creator><creator>Souza, Fábio Solano de Freitas</creator><creator>Avila, Luiz Francisco Rodrigues de</creator><creator>Parga Filho, José Rodrigues</creator><creator>César, Luiz Antônio Machado</creator><creator>Izaki, Marisa</creator><creator>Meneghetti, José Cláudio</creator><creator>Rochitte, Carlos Eduardo</creator><creator>Kalil Filho, Roberto</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>200808</creationdate><title>Magnetic resonance vs technetium-99m pyrophosphate scintigraphy in the detection of perioperative myocardial necrosis</title><author>Monte, Guilherme Urpia ; Drager, Luciano Ferreira ; Souza, Fábio Solano de Freitas ; Avila, Luiz Francisco Rodrigues de ; Parga Filho, José Rodrigues ; César, Luiz Antônio Machado ; Izaki, Marisa ; Meneghetti, José Cláudio ; Rochitte, Carlos Eduardo ; Kalil Filho, Roberto</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p188t-e92037aa240ec00f35fb68ca7c611ed7717ed124a2fe6535558582bf5dd520343</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng ; por</language><creationdate>2008</creationdate><topic>Biomarkers - blood</topic><topic>Chronic Disease</topic><topic>Coronary Disease - blood</topic><topic>Coronary Disease - surgery</topic><topic>Creatine Kinase, MB Form - blood</topic><topic>Female</topic><topic>Humans</topic><topic>Intraoperative Complications</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - diagnostic imaging</topic><topic>Myocardial Infarction - pathology</topic><topic>Myocardial Revascularization</topic><topic>Necrosis</topic><topic>Radionuclide Imaging</topic><topic>Radiopharmaceuticals</topic><topic>Sensitivity and Specificity</topic><topic>Technetium Tc 99m Pyrophosphate</topic><topic>Troponin I - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Monte, Guilherme Urpia</creatorcontrib><creatorcontrib>Drager, Luciano Ferreira</creatorcontrib><creatorcontrib>Souza, Fábio Solano de Freitas</creatorcontrib><creatorcontrib>Avila, Luiz Francisco Rodrigues de</creatorcontrib><creatorcontrib>Parga Filho, José Rodrigues</creatorcontrib><creatorcontrib>César, Luiz Antônio Machado</creatorcontrib><creatorcontrib>Izaki, Marisa</creatorcontrib><creatorcontrib>Meneghetti, José Cláudio</creatorcontrib><creatorcontrib>Rochitte, Carlos Eduardo</creatorcontrib><creatorcontrib>Kalil Filho, Roberto</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Arquivos brasileiros de cardiologia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Monte, Guilherme Urpia</au><au>Drager, Luciano Ferreira</au><au>Souza, Fábio Solano de Freitas</au><au>Avila, Luiz Francisco Rodrigues de</au><au>Parga Filho, José Rodrigues</au><au>César, Luiz Antônio Machado</au><au>Izaki, Marisa</au><au>Meneghetti, José Cláudio</au><au>Rochitte, Carlos Eduardo</au><au>Kalil Filho, Roberto</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Magnetic resonance vs technetium-99m pyrophosphate scintigraphy in the detection of perioperative myocardial necrosis</atitle><jtitle>Arquivos brasileiros de cardiologia</jtitle><addtitle>Arq Bras Cardiol</addtitle><date>2008-08</date><risdate>2008</risdate><volume>91</volume><issue>2</issue><spage>113</spage><epage>118</epage><pages>113-118</pages><eissn>1678-4170</eissn><abstract>Perioperative myocardial infarction (POMI) is a complication of coronary artery bypass grafting (CABG) with a potential prognostic impact. Technetium-99m pyrophosphate myocardial scintigraphy (MS) is used in the diagnosis of POMI; however it shows a limited sensitivity for subendocardial lesions. Cardiovascular magnetic resonance imaging (CMRI), in turn, has a high accuracy in the detection of myocardial necrosis.
To compare CMRI and MS for the detection of POMI after CABG.
A total of 24 patients with chronic coronary artery disease were studied using the delayed contrast enhanced CMRI and MS before and after CABG by analyzing the development of areas of perioperative myocardial necrosis (POMI). Biochemical markers of myocardial injury (CKMB and troponin I) were also determined before and after surgery.
Nineteen patients completed the study. Of these, 6 (32%) presented POMI on CMRI and 4 (21%) on MS (p = NS). Of the 323 left ventricular segments assessed, 17 (5.3%) showed perioperative necrosis on CMRI and 7 (2.2%) on MS (p = 0.013). Moderate agreement was observed between the methods (kappa = 0.46). There was disagreement regarding the diagnosis of POMI in 4 (21%) cases, most of them with small areas of perioperative necrosis on CMRI which were not visualized on MS. In all cases with POMI on CMRI, significant CKMB and troponin I elevations were observed.
Moderate diagnostic agreement was observed between the methods for the detection of POMI, but CMRI enabled visualization of small areas of perioperative myocardial necrosis which were not identified on MS and were associated with elevation of biochemical markers of myocardial injury.</abstract><cop>Brazil</cop><pmid>18709263</pmid><doi>10.1590/S0066-782X2008001400009</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Biomarkers - blood Chronic Disease Coronary Disease - blood Coronary Disease - surgery Creatine Kinase, MB Form - blood Female Humans Intraoperative Complications Magnetic Resonance Imaging Male Middle Aged Myocardial Infarction - diagnostic imaging Myocardial Infarction - pathology Myocardial Revascularization Necrosis Radionuclide Imaging Radiopharmaceuticals Sensitivity and Specificity Technetium Tc 99m Pyrophosphate Troponin I - blood |
| title | Magnetic resonance vs technetium-99m pyrophosphate scintigraphy in the detection of perioperative myocardial necrosis |
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