학술대회 안내 사전등록 안내 초록등록 안내 초록등록/관리 숙박및교통 안내


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Correlation analysis between dobutamine echocardiography, sestamibi single-photon emission computed tomography, and magnetic resonance imaging in assessment of patients with postinfarction left ventricular dysfunction
서울대학교병원
장호준, 최윤식, 박영배, 오병희, 손대원, 김효수, 조주희, 장혁재
Aim: We sought to establish the degree of correlation among the dobutamine stress echocardiography (DSE), thallium single-photon emission computed tomography (Tl-SPECT), and magnetic resonance imaging (MRI) in assessing cardiac contractile function and myocardial wall motion in patients with chronic coronary artery disease. Methods: Twenty two patients with postinfarction left ventricular dysfunction due to myocardial infarction underwent standard dobutamine stress echocardiography, thallium single-photon emission computed tomography, and magnetic resonance imaging before and six months after percutaneous coronary revascularization. To analyze myocardial wall motion by Tl-SPECT and MRI, 16 cardiac segments protocol according to American Society of Echocardiography were established. All the analyzed segments were scored and we calculated the average value of wall motion signal index. Results: 1) There were good correlations among Tl-SPECT, MRI, and DSE in the analysis of the end diastolic volume(EDV), end systolic volume(ESV), and ejection fraction(EF), but poor correlations were observed in the analysis of stroke volume, which is calculated as (EDV – ESD). Those patterns of correlations were similar in subgroup analysis dividing AMI and OMI groups. 2) In the correlation analysis of EF before and six months after revascularization, poor correlations were observed between MRI and DSE results, otherwise good correlations were observed. 3) In the evaluation of wall motion signal index value, they showed good correlation among MRI, Tl-SPECT contractility, and Tl-SPECT perfusion. In subgroup analysis, poor correlation was observed between MRI and Tl-SPECT contractility, and interestingly, between Tl-SPECT contractility and Tl-SPECT perfusion on the OMI group. Conclusions: The results of our study showed all the modalities are useful in evaluation of ventricular function as a whole. Though three modalities showed generally similar correlations in evaluating wall motion, there were poor correlations in evaluation of OMI patients. Scar formation in OMI might cause discordance between impairment of perfusion and of contractility, resulting those poor correlations.


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