학술대회 발표 연제 초록

^{Aim: We sought to establish the degree of correlation among dobutamine stress echocardiography (DSE), sestamibi single-photon emission computed tomography (SPECT), and magnetic resonance imaging (MRI) in assessing cardiac contractile function and myocardial viability in patients with chronic coronary artery disease.

Methods and results: The study group was comprised of patients prospectively enrolled in MAGIC cell trial. 56 patients with postinfarction left ventricular dysfunction due to old myocardial infarction underwent standard dobutamine echocardiography, sestamibi single-photon emission computed tomography, and magnetic resonance imaging within two weeks of time interval. To analyze the same cardiac segments by 3 tests, 16 cardiac segments protocol according to the American Society of Echocardiography was established. All the analyzed segments were scored as follows: 1 = normokinetic, 2 = mild to moderately hypokinetic, 3 = severely hypokinetic but viable, 4 = akinetic, nonviable.
A total of 896 cardiac segments (16 segments in 56 patients) were analyzed. In the correlation analysis of the systolic volume, diastolic volume, and ejection fraction, they showed good correlation (kappa >0.80) between SPECT, MRI and DSE. In the segmental one to one comparison of the 16 compartment of the heart on SPECT, MRI and DSE, however, they showed moderate to poor correlation on kappa value analysis.

Conclusions: This results shows all the modalities is useful in evaluation of ventricular function as a whole. However, the direct comparison between the coincidential segments of the heart might not be correlated well. These discrepancies in assessing viability by SPECT, MRI, and DSE might be due to differences in the minimum critical mass of live myocytes required by each modality to diagnose viability. In addition, regional, grouped comparison such as the territorial comparison according to the vascular supply might be more beneficial in the comparison between the three differential modalities.}