Myocardial viability assessment by endocardial electroanatomic mapping: comparison with metabolic imaging and functional recovery after coronary revascularization
OBJECTIVES The objective of this study was to compare electroanatomic mapping for the assessment of myocardial viability with nuclear metabolic imaging using positron emission computed tomography (PET) and with data on functional recovery after successful myocardial revascularization. BACKGROUND Ani...
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| Veröffentlicht in: | Journal of the American College of Cardiology 2001-07, Vol.38 (1), p.91-98 |
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| creator | Koch, Karl-Christian vom Dahl, Juergen Wenderdel, Monika Nowak, Bernd Schaefer, Wolfgang M Sasse, Alexander Stellbrink, Christoph Buell, Udalrich Hanrath, Peter |
| description | OBJECTIVES
The objective of this study was to compare electroanatomic mapping for the assessment of myocardial viability with nuclear metabolic imaging using positron emission computed tomography (PET) and with data on functional recovery after successful myocardial revascularization.
BACKGROUND
Animal experiments and first clinical studies suggested that electroanatomic endocardial mapping identifies the presence and absence of myocardial viability.
METHODS
Forty-six patients with prior (≥2 weeks) myocardial infarction underwent fluorine-18 fluorodeoxyglucose (FDG) PET and Tc-99m sestamibi single-photon emission computed tomography (SPECT) before mapping and percutaneous coronary revascularization. The left ventricular endocardium was mapped and divided into 12 regions, which were assigned to corresponding nuclear regions. Functional recovery using the centerline method was assessed in 25 patients with a follow-up angiography.
RESULTS
Regional unipolar electrogram amplitude was 11.0 mV ± 3.6 mV in regions with normal perfusion, 9.0 mV ± 2.8 mV in regions with reduced perfusion and preserved FDG-uptake and 6.5 mV ± 2.6 mV in scar regions (p < 0.001 for all comparisons). At a threshold amplitude of 7.5 mV, the sensitivity and specificity for detecting viable (by PET/SPECT) myocardium were 77% and 75%, respectively. In infarct areas with electrogram amplitudes >7.5 mV, improvement of regional wall motion (RWM) from −2.4 SD/chord ± 1.0 SD/chord to −1.5 SD/chord ± 1.1 SD/chord (p < 0.01) was observed, whereas, in infarct areas with amplitudes |
| doi_str_mv | 10.1016/S0735-1097(01)01314-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70984954</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0735109701013146</els_id><sourcerecordid>70984954</sourcerecordid><originalsourceid>FETCH-LOGICAL-c522t-f440d7a731314d3e3e20584dc8fe408e510fd33bd40533531ed48d92cc2df0a23</originalsourceid><addsrcrecordid>eNqFkc2OFCEUhYlx4rSjj6BhYSa6KIUC6seNmUzUMRnjQl2TW3BrxFRBCVSb9nF8UunpzujOFYF859zLOYQ84ewlZ7x59Zm1QlWc9e1zxl8wLrismntkw5XqKqH69j7Z3CGn5GFK3xljTcf7B-SUc6m4YPWG_P64CwaidTDRrYPBTS7vKKSEKc3oMx12FL29Y3BCk2MADznMztAZlsX5m9fUhHmB6FLw9KfL3-iMGYYwFcTNcFMQCt7ScfUmu-CLU0QTthjLsDFjLPpYnss14haSWadi9gv27CNyMsKU8PHxPCNf3739cnlVXX96_-Hy4royqq5zNUrJbAut2EdhBQqsmeqkNd2IknWoOButEIOVTAmhBEcrO9vXxtR2ZFCLM3J-8F1i-LFiynp2yeA0gcewJt2yvpO9kgVUB9DEkFLEUS-xfDLuNGd6X46-LUfvk9eM69tydFN0T48D1mFG-1d1bKMAz45ASQCmMYI3Lv3j3tVNLwr25oBhSWPrMOpkHHqD1pVQs7bB_WeTPy3QsKE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70984954</pqid></control><display><type>article</type><title>Myocardial viability assessment by endocardial electroanatomic mapping: comparison with metabolic imaging and functional recovery after coronary revascularization</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Koch, Karl-Christian ; vom Dahl, Juergen ; Wenderdel, Monika ; Nowak, Bernd ; Schaefer, Wolfgang M ; Sasse, Alexander ; Stellbrink, Christoph ; Buell, Udalrich ; Hanrath, Peter</creator><creatorcontrib>Koch, Karl-Christian ; vom Dahl, Juergen ; Wenderdel, Monika ; Nowak, Bernd ; Schaefer, Wolfgang M ; Sasse, Alexander ; Stellbrink, Christoph ; Buell, Udalrich ; Hanrath, Peter</creatorcontrib><description>OBJECTIVES
The objective of this study was to compare electroanatomic mapping for the assessment of myocardial viability with nuclear metabolic imaging using positron emission computed tomography (PET) and with data on functional recovery after successful myocardial revascularization.
BACKGROUND
Animal experiments and first clinical studies suggested that electroanatomic endocardial mapping identifies the presence and absence of myocardial viability.
METHODS
Forty-six patients with prior (≥2 weeks) myocardial infarction underwent fluorine-18 fluorodeoxyglucose (FDG) PET and Tc-99m sestamibi single-photon emission computed tomography (SPECT) before mapping and percutaneous coronary revascularization. The left ventricular endocardium was mapped and divided into 12 regions, which were assigned to corresponding nuclear regions. Functional recovery using the centerline method was assessed in 25 patients with a follow-up angiography.
RESULTS
Regional unipolar electrogram amplitude was 11.0 mV ± 3.6 mV in regions with normal perfusion, 9.0 mV ± 2.8 mV in regions with reduced perfusion and preserved FDG-uptake and 6.5 mV ± 2.6 mV in scar regions (p < 0.001 for all comparisons). At a threshold amplitude of 7.5 mV, the sensitivity and specificity for detecting viable (by PET/SPECT) myocardium were 77% and 75%, respectively. In infarct areas with electrogram amplitudes >7.5 mV, improvement of regional wall motion (RWM) from −2.4 SD/chord ± 1.0 SD/chord to −1.5 SD/chord ± 1.1 SD/chord (p < 0.01) was observed, whereas, in infarct areas with amplitudes <7.5 mV, RWM remained unchanged at follow-up (−2.3 SD/chord ± 0.7 SD/chord to −2.4 SD/chord ± 0.7 SD/chord).
CONCLUSIONS
These data suggest that the regional unipolar electrogram amplitude is a marker for myocardial viability and that electroanatomic mapping can be used for viability assessment in the catheterization laboratory.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/S0735-1097(01)01314-6</identifier><identifier>PMID: 11451302</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Angioplasty, Balloon, Coronary ; Biological and medical sciences ; Cardiology. Vascular system ; Coronary heart disease ; Electrophysiologic Techniques, Cardiac ; Endocardium - physiology ; Female ; Heart ; Heart - diagnostic imaging ; Humans ; Male ; Medical sciences ; Middle Aged ; Myocardial Infarction - diagnostic imaging ; Myocardial Infarction - pathology ; Myocardial Infarction - therapy ; Myocardium - metabolism ; Radiopharmaceuticals ; Sensitivity and Specificity ; Signal Processing, Computer-Assisted ; Technetium Tc 99m Sestamibi ; Tomography, Emission-Computed ; Tomography, Emission-Computed, Single-Photon ; Ventricular Function</subject><ispartof>Journal of the American College of Cardiology, 2001-07, Vol.38 (1), p.91-98</ispartof><rights>2001 American College of Cardiology</rights><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c522t-f440d7a731314d3e3e20584dc8fe408e510fd33bd40533531ed48d92cc2df0a23</citedby><cites>FETCH-LOGICAL-c522t-f440d7a731314d3e3e20584dc8fe408e510fd33bd40533531ed48d92cc2df0a23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0735109701013146$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1082693$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11451302$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Koch, Karl-Christian</creatorcontrib><creatorcontrib>vom Dahl, Juergen</creatorcontrib><creatorcontrib>Wenderdel, Monika</creatorcontrib><creatorcontrib>Nowak, Bernd</creatorcontrib><creatorcontrib>Schaefer, Wolfgang M</creatorcontrib><creatorcontrib>Sasse, Alexander</creatorcontrib><creatorcontrib>Stellbrink, Christoph</creatorcontrib><creatorcontrib>Buell, Udalrich</creatorcontrib><creatorcontrib>Hanrath, Peter</creatorcontrib><title>Myocardial viability assessment by endocardial electroanatomic mapping: comparison with metabolic imaging and functional recovery after coronary revascularization</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>OBJECTIVES
The objective of this study was to compare electroanatomic mapping for the assessment of myocardial viability with nuclear metabolic imaging using positron emission computed tomography (PET) and with data on functional recovery after successful myocardial revascularization.
BACKGROUND
Animal experiments and first clinical studies suggested that electroanatomic endocardial mapping identifies the presence and absence of myocardial viability.
METHODS
Forty-six patients with prior (≥2 weeks) myocardial infarction underwent fluorine-18 fluorodeoxyglucose (FDG) PET and Tc-99m sestamibi single-photon emission computed tomography (SPECT) before mapping and percutaneous coronary revascularization. The left ventricular endocardium was mapped and divided into 12 regions, which were assigned to corresponding nuclear regions. Functional recovery using the centerline method was assessed in 25 patients with a follow-up angiography.
RESULTS
Regional unipolar electrogram amplitude was 11.0 mV ± 3.6 mV in regions with normal perfusion, 9.0 mV ± 2.8 mV in regions with reduced perfusion and preserved FDG-uptake and 6.5 mV ± 2.6 mV in scar regions (p < 0.001 for all comparisons). At a threshold amplitude of 7.5 mV, the sensitivity and specificity for detecting viable (by PET/SPECT) myocardium were 77% and 75%, respectively. In infarct areas with electrogram amplitudes >7.5 mV, improvement of regional wall motion (RWM) from −2.4 SD/chord ± 1.0 SD/chord to −1.5 SD/chord ± 1.1 SD/chord (p < 0.01) was observed, whereas, in infarct areas with amplitudes <7.5 mV, RWM remained unchanged at follow-up (−2.3 SD/chord ± 0.7 SD/chord to −2.4 SD/chord ± 0.7 SD/chord).
CONCLUSIONS
These data suggest that the regional unipolar electrogram amplitude is a marker for myocardial viability and that electroanatomic mapping can be used for viability assessment in the catheterization laboratory.</description><subject>Aged</subject><subject>Angioplasty, Balloon, Coronary</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Coronary heart disease</subject><subject>Electrophysiologic Techniques, Cardiac</subject><subject>Endocardium - physiology</subject><subject>Female</subject><subject>Heart</subject><subject>Heart - diagnostic imaging</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - diagnostic imaging</subject><subject>Myocardial Infarction - pathology</subject><subject>Myocardial Infarction - therapy</subject><subject>Myocardium - metabolism</subject><subject>Radiopharmaceuticals</subject><subject>Sensitivity and Specificity</subject><subject>Signal Processing, Computer-Assisted</subject><subject>Technetium Tc 99m Sestamibi</subject><subject>Tomography, Emission-Computed</subject><subject>Tomography, Emission-Computed, Single-Photon</subject><subject>Ventricular Function</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc2OFCEUhYlx4rSjj6BhYSa6KIUC6seNmUzUMRnjQl2TW3BrxFRBCVSb9nF8UunpzujOFYF859zLOYQ84ewlZ7x59Zm1QlWc9e1zxl8wLrismntkw5XqKqH69j7Z3CGn5GFK3xljTcf7B-SUc6m4YPWG_P64CwaidTDRrYPBTS7vKKSEKc3oMx12FL29Y3BCk2MADznMztAZlsX5m9fUhHmB6FLw9KfL3-iMGYYwFcTNcFMQCt7ScfUmu-CLU0QTthjLsDFjLPpYnss14haSWadi9gv27CNyMsKU8PHxPCNf3739cnlVXX96_-Hy4royqq5zNUrJbAut2EdhBQqsmeqkNd2IknWoOButEIOVTAmhBEcrO9vXxtR2ZFCLM3J-8F1i-LFiynp2yeA0gcewJt2yvpO9kgVUB9DEkFLEUS-xfDLuNGd6X46-LUfvk9eM69tydFN0T48D1mFG-1d1bKMAz45ASQCmMYI3Lv3j3tVNLwr25oBhSWPrMOpkHHqD1pVQs7bB_WeTPy3QsKE</recordid><startdate>20010701</startdate><enddate>20010701</enddate><creator>Koch, Karl-Christian</creator><creator>vom Dahl, Juergen</creator><creator>Wenderdel, Monika</creator><creator>Nowak, Bernd</creator><creator>Schaefer, Wolfgang M</creator><creator>Sasse, Alexander</creator><creator>Stellbrink, Christoph</creator><creator>Buell, Udalrich</creator><creator>Hanrath, Peter</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20010701</creationdate><title>Myocardial viability assessment by endocardial electroanatomic mapping: comparison with metabolic imaging and functional recovery after coronary revascularization</title><author>Koch, Karl-Christian ; vom Dahl, Juergen ; Wenderdel, Monika ; Nowak, Bernd ; Schaefer, Wolfgang M ; Sasse, Alexander ; Stellbrink, Christoph ; Buell, Udalrich ; Hanrath, Peter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c522t-f440d7a731314d3e3e20584dc8fe408e510fd33bd40533531ed48d92cc2df0a23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Aged</topic><topic>Angioplasty, Balloon, Coronary</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Coronary heart disease</topic><topic>Electrophysiologic Techniques, Cardiac</topic><topic>Endocardium - physiology</topic><topic>Female</topic><topic>Heart</topic><topic>Heart - diagnostic imaging</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - diagnostic imaging</topic><topic>Myocardial Infarction - pathology</topic><topic>Myocardial Infarction - therapy</topic><topic>Myocardium - metabolism</topic><topic>Radiopharmaceuticals</topic><topic>Sensitivity and Specificity</topic><topic>Signal Processing, Computer-Assisted</topic><topic>Technetium Tc 99m Sestamibi</topic><topic>Tomography, Emission-Computed</topic><topic>Tomography, Emission-Computed, Single-Photon</topic><topic>Ventricular Function</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koch, Karl-Christian</creatorcontrib><creatorcontrib>vom Dahl, Juergen</creatorcontrib><creatorcontrib>Wenderdel, Monika</creatorcontrib><creatorcontrib>Nowak, Bernd</creatorcontrib><creatorcontrib>Schaefer, Wolfgang M</creatorcontrib><creatorcontrib>Sasse, Alexander</creatorcontrib><creatorcontrib>Stellbrink, Christoph</creatorcontrib><creatorcontrib>Buell, Udalrich</creatorcontrib><creatorcontrib>Hanrath, Peter</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koch, Karl-Christian</au><au>vom Dahl, Juergen</au><au>Wenderdel, Monika</au><au>Nowak, Bernd</au><au>Schaefer, Wolfgang M</au><au>Sasse, Alexander</au><au>Stellbrink, Christoph</au><au>Buell, Udalrich</au><au>Hanrath, Peter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Myocardial viability assessment by endocardial electroanatomic mapping: comparison with metabolic imaging and functional recovery after coronary revascularization</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2001-07-01</date><risdate>2001</risdate><volume>38</volume><issue>1</issue><spage>91</spage><epage>98</epage><pages>91-98</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>OBJECTIVES
The objective of this study was to compare electroanatomic mapping for the assessment of myocardial viability with nuclear metabolic imaging using positron emission computed tomography (PET) and with data on functional recovery after successful myocardial revascularization.
BACKGROUND
Animal experiments and first clinical studies suggested that electroanatomic endocardial mapping identifies the presence and absence of myocardial viability.
METHODS
Forty-six patients with prior (≥2 weeks) myocardial infarction underwent fluorine-18 fluorodeoxyglucose (FDG) PET and Tc-99m sestamibi single-photon emission computed tomography (SPECT) before mapping and percutaneous coronary revascularization. The left ventricular endocardium was mapped and divided into 12 regions, which were assigned to corresponding nuclear regions. Functional recovery using the centerline method was assessed in 25 patients with a follow-up angiography.
RESULTS
Regional unipolar electrogram amplitude was 11.0 mV ± 3.6 mV in regions with normal perfusion, 9.0 mV ± 2.8 mV in regions with reduced perfusion and preserved FDG-uptake and 6.5 mV ± 2.6 mV in scar regions (p < 0.001 for all comparisons). At a threshold amplitude of 7.5 mV, the sensitivity and specificity for detecting viable (by PET/SPECT) myocardium were 77% and 75%, respectively. In infarct areas with electrogram amplitudes >7.5 mV, improvement of regional wall motion (RWM) from −2.4 SD/chord ± 1.0 SD/chord to −1.5 SD/chord ± 1.1 SD/chord (p < 0.01) was observed, whereas, in infarct areas with amplitudes <7.5 mV, RWM remained unchanged at follow-up (−2.3 SD/chord ± 0.7 SD/chord to −2.4 SD/chord ± 0.7 SD/chord).
CONCLUSIONS
These data suggest that the regional unipolar electrogram amplitude is a marker for myocardial viability and that electroanatomic mapping can be used for viability assessment in the catheterization laboratory.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>11451302</pmid><doi>10.1016/S0735-1097(01)01314-6</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Angioplasty, Balloon, Coronary Biological and medical sciences Cardiology. Vascular system Coronary heart disease Electrophysiologic Techniques, Cardiac Endocardium - physiology Female Heart Heart - diagnostic imaging Humans Male Medical sciences Middle Aged Myocardial Infarction - diagnostic imaging Myocardial Infarction - pathology Myocardial Infarction - therapy Myocardium - metabolism Radiopharmaceuticals Sensitivity and Specificity Signal Processing, Computer-Assisted Technetium Tc 99m Sestamibi Tomography, Emission-Computed Tomography, Emission-Computed, Single-Photon Ventricular Function |
| title | Myocardial viability assessment by endocardial electroanatomic mapping: comparison with metabolic imaging and functional recovery after coronary revascularization |
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