Infarct size measured by single photon emission computed tomographic imaging with 99mTc-sestamibi -: A measure of the efficacy of therapy in acute myocardial infarction
Infarct size measured by single photon emission computed tomographic imaging with 99mTc-sestamibi -: A measure of the efficacy of therapy in acute myocardial infarction
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DOI：
10.1161/01.cir.101.1.101
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发表时间：
2000-01-04
期刊：
影响因子：
37.8
通讯作者：
Christian, TF
中科院分区：
文献类型：
--
作者：
Gibbons, RJ;Miller, TD;Christian, TF
背景-在再灌注治疗的随机试验中，使用死亡率作为终点需要越来越大的样本量来测试与已经非常有效的现有治疗相比的进步。有越来越多的兴趣在梗死面积测量Tc-99 m-sestamibi SPECT（单光子发射计算机断层扫描）成像作为一个替代endpoint.Methods和结果，我们回顾了英文发表的关于梗死面积测量Tc-99 m-sestamibi的报告。四条独立的已发表证据支持99 mTc-sestamibi SPECT成像测定梗死面积的有效性。该终点已在总共7项随机试验中使用-1项单中心和6项多中心。该终点与使用其他放射性药物测量的左心室功能和梗死面积相比是有利的。这种方法的最重要的局限性是迄今为止没有一个随机试验，已显示出相应的降低死亡率与治疗，减少梗死size.Conclusions-SPECT显像与Tc-99 m-sestamibi是最好的测量工具梗死面积。它已经作为早期试点研究的终点，以评估潜在的疗效和剂量范围研究。它有可能作为一个替代终点，揭示新疗法的优势，可能等同于现有的治疗早期死亡率。
Background-Use of mortality as an end point in randomized trials of reperfusion therapy requires increasingly large sample sizes to test advances compared with existing therapy, which is already highly effective. There has been a growing interest in infarct size measurements by Tc-99m-sestamibi SPECT(single photon emission computed tomographic) imaging as a surrogate end point.Methods and Results-We reviewed the reports published in English regarding infarct size measurements by Tc-99m-sestamibi. Four separate lines of published evidence support the validity of SPECT imaging with 99mTc-sestamibi for determination of infarct size. This end point has been used in a total of 7 randomized trials-1 single center and 6 multicenter. The end point compares favorably with left ventricular function and infarct size measurements with the use of other radiopharmaceuticals. The most important limitation of this approach is the absence thus far of a randomized trial that has shown a corresponding decrease in mortality in association with a therapy that reduces infarct size.Conclusions-SPECT imaging with Tc-99m-sestamibi is the best available measurement tool for infarct size. It has already served as an end point in early pilot studies to evaluate potential efficacy and in dose-ranging studies. It has the potential to serve as a surrogate end point to uncover advantages of new therapies that may be equivalent to existing therapies with respect to early mortality.