Rest-redistribution thallium-201 and rest technetium-99m-sestamibi SPECT in patients with stable coronary artery disease and ventricular dysfunction

Resting sestamibi uptake was compared with ²⁰¹TI rest-redistribution uptake in 48 patients with ischemic heart disease and regional ventricular asynergies. Methods: In 48 patients, rest/4-hr redistribution ²⁰¹TI and resting sestamibi tomography were closely performed on separate days. Segmental tracer uptake was quantified. Wall motion in corresponding segments was also assessed by two-dimensional echocardiography in 17 patients. Results: Quantitative analysis indicates that the uptake of the two tracers was comparable in normal segments as well as in segments with fixed ²⁰¹TI defects. In contrast, in segments with reversible ²⁰¹TI defects, sestamibi uptake was significantly lower than redistribution ²⁰¹TI uptake. Conclusion: In patients with chronic ischemic heart disease and regional asynergies, quantified sestamibi activity parallels ²⁰¹TI redistribution activity in normal segments and in those with fixed ²⁰¹TI defects. In segments showing reversible ²⁰¹TI defects, whether or not dysfunctioning, sestamibi uptake is significantly lower than ²⁰¹TI redistribution.