Electromechanical mapping versus positron emission tomography and single photon emission computed tomography for the detection of myocardial viability in patients with ischemic cardiomyopathy
Henrik Wiggers, MD, PhD*,*,
Hans Erik Bøtker, MD, PhD*,
Peter Søgaard, MD, PhD*,
Anne Kaltoft, MD*,
Flemming Hermansen, MD ,
Won Yong Kim, MD, PhD*,
Lars Krusell, MD* and
Leif Thuesen, MD, PhD*
* Department of Cardiology, Skejby Hospital, Aarhus University Hospital, Aarhus, Denmark
The PET Center, Aarhus Kommunehospital, Aarhus University Hospital, Aarhus, Denmark
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Figure 1 The receiver operating characteristics curve for the distinction between dysfunctional myocardium with and without functional recovery at follow-up. Tracer uptake had better test characteristics (solid line; area under curve [AUC] ± SE, 0.82 ± 0.04) than normalized unipolar voltage amplitude (UVA) (dashed line; AUC ± SE, 0.70 ± 0.05, p < 0.05 vs. tracer uptake) and absolute UVA (dotted line; AUC ± SE, 0.63 ± 0.05, p < 0.05 vs. tracer uptake). Normalization of UVA tended to improved the diagnostic accuracy of electromechanical mapping (p = 0.09 vs. UVA).
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Figure 2 Sensitivity and specificity for the distinction between reversibly dysfunctional myocardium (RDM) and irreversibly dysfunctional myocardium are shown at various thresholds of (A) unipolar voltage amplitude (UVA), (B) normalized UVA, and (C) tracer uptake. Optimal threshold was defined as the value yielding sensitivity = specificity for the prediction of RDM. Sensitivity and specificity were 59% at a UVA of 8.4 mV, 65% at a normalized UVA of 83%, and 78% at a tracer uptake of 69%.
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