medvisМедицинская визуализацияMedical Visualization1607-07632408-9516RDS-Media Ltd.10.24835/1607-0763-1230medvis-1272Research ArticleСЕРДЦЕHEARTИспользование меченного технецием-99m аналога соматостатина у больных с подострым инфарктом миокарда и в отдаленном периоде: первый опытTechnetium-99m labelled somatostatin analogue myocardial uptake in subacute and “old” myocardial infarction: initial experiencehttps://orcid.org/0000-0002-8649-3648ИльюшенковаЮ. Н.IlyushenkovaJ. N.

Ильюшенкова Юлия Николаевна – кандидат медицинских наук, старший научный сотрудник лаборатории радионуклидных методов исследования

634012 Томск, ул. Киевская, 111A

Julia N. Ilyushenkova – Cand. of Sci. (Med.), Senior Research Officer of the Nuclear Medicine Department

11A, Kievskaya str., Tomsk 634012

ilyushenkova_cardio@mail.ruhttps://orcid.org/0000-0001-5581-5387СыркинаА. Г.SyrkinaA. G.

Сыркина Анна Геннадьевна – кандидат медицинских наук, научный сотрудник отделения неотложной кардиологии

634012 Томск, ул. Киевская, 111A

Anna G. Syrkina – Cand. of Sci. (Med.), Research Officer of the Emergency Cardiology Department

11A, Kievskaya str., Tomsk 634012

sag@cardio-tomsk.ruhttps://orcid.org/0000-0003-4051-3196ТрусовА. А.TrusovA. A.

Трусов Андрей Андреевич – аспирант, младший научный сотрудник отделения неотложной кардиологии

634012 Томск, ул. Киевская, 111A

Andrei A. Trusov – Ph.D student, Junior Research Officer of the Emergency Cardiology Department

11A, Kievskaya str., Tomsk 634012

truan94@mail.ruhttps://orcid.org/0000-0001-9453-1635МишкинаА. И.MishkinaA. I.

Мишкина Анна Ивановна – кандидат медицинских наук, научный сотрудник лаборатории радионуклидных методов исследования

634012 Томск, ул. Киевская, 111A

Anna I. Mishkina – Cand. of Sci. (Med.), Research Officier of the Nuclear Medicine Department

11A, Kievskaya str., Tomsk 634012

anna123.2013@gmail.comhttps://orcid.org/0000-0002-7502-7502МочулаО. В.MochulaO. V.

Мочула Ольга Витальевна – кандидат медицинских наук, научный сотрудник отделения рентгеновских и томографических методов диагностики

634012 Томск, ул. Киевская, 111A

Olga V. Mochula – Cand. of Sci. (Med.), Research Officier of the X-ray and Tomographic Diagnostic Methods Department

11A, Kievskaya str., Tomsk 634012

mochula.olga@gmail.comhttps://orcid.org/0000-0003-2799-3260СазоноваС. И.SazonovaS. I.

Сазонова Светлана Ивановна – доктор медицинских наук, ведущий научный сотрудник лаборатории радионуклидных методов исследования

634012 Томск, ул. Киевская, 111A

Svetlana I. Sazonova – Doct. of Sci. (Med.), Leading Research Officer of the Nuclear Medicine Department

11A, Kievskaya str., Tomsk 634012

sazonova_si@mail.ruhttps://orcid.org/0000-0002-4358-7329РябовВ. В.RyabovV. V.

Рябов Вячеслав Валерьевич – доктор медицинских наук, руководитель отделения неотложной кардиологии

634012 Томск, ул. Киевская, 111A

Vyacheslav V. Ryabov – Doct. of Sci. (Med.), Head of the Emergency Cardiology Department

11A, Kievskaya str., Tomsk 634012

rvvt@cardio-tomsk.ruНаучно-исследовательский институт кардиологии Федерального государственного бюджетного научного учреждения “Томский национальный исследовательский медицинский центр Российской академии наук”РоссияCardiology research Institute, Tomsk National medical research Center of the Russian Academy of SciencesRussian Federation20222110202226493101Copyright © Ильюшенкова Ю.Н., Сыркина А.Г., Трусов А.А., Мишкина А.И., Мочула О.В., Сазонова С.И., Рябов В.В., 20222022Ильюшенкова Ю.Н., Сыркина А.Г., Трусов А.А., Мишкина А.И., Мочула О.В., Сазонова С.И., Рябов В.В.Ilyushenkova J.N., Syrkina A.G., Trusov A.A., Mishkina A.I., Mochula O.V., Sazonova S.I., Ryabov V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medvis.rdsmedia.ru/jour/article/view/1272Введение

Введение. Показано, что прогноз после острого инфаркта (ИМ) имеет сильную корреляционную взаимосвязь с интенсивностью воспалительной реакции в ответ на повреждение миокарда. В связи с этим для мониторинга постинфарктного воспаления требуются новые диагностические подходы. Сцинтиграфия с меченными технецием-99m аналогами сомастостатина является перспективным методом визуализации постинфарктного воспаления, однако ее клиническое значение мало изучено.

Материал и методы

Материал и методы. В исследование включено 6 пациентов с передним ИМ с подъемом сегмента ST. Всем пациентам была проведена ОФЭКТ-КТ грудной клетки 99mТс-тектротидом и перфузионная сцинтиграфия миокарда в состоянии покоя в подостром и отдаленном (8 мес) периоде.

Результаты

Результаты. В подостром периоде дефекты перфузии миокарда были выявлены у всех пациентов (SRS 11.83 ± 8.89). В то же время накопление 99mТс-тектротида в миокарде было выявлено у 3 пациентов из 6 обследованных. В отдаленном периоде интенсивное накопление 99mТс-тектротида отмечалось только у 1 пациента из 6 и носило более распространенный характер по сравнению с подострым периодом ИМ.

Заключение

Заключение. Сцинтиграфия миокарда с 99mТс-тектротидом позволяет выявить сверхэкспрессию рецепторов соматостатина у пациентов, перенесших ИМ как в подостром, так и в отдаленном периоде.

Background

Background. It has been shown that prognosis following acute myocardial infarction (MI) strongly correlates with intensity of inflammatory reactions in response to myocardial injury. Thereby diagnostic methods for myocardial post-infarction inflammation (PII) monitoring are needed. Scintigraphy with somatostatin receptor targeted radiotracers has prospects for PII imaging, but its clinical value is poorly studied.

Methods

Methods. Six patients with ST-segment elevation anterior myocardial infarction (STEMI) were examined by chest SPECT/СT with 99mTc-Tektrotyd and rest myocardial perfusion scintigraphy (MPS) at subacute and remote (8 th month) period of the disease. Parameters of both scintigraphic methods were estimated.

Results

Results. In subacute stage of MI myocardial perfusion defects were revealed in all 6 patients (mean SRS 11.83 ± 8.89), 99mTc-Tektrotyd uptake in myocardium was revealed in 3 of 6 patients. At remote period intense uptake of 99mTc-Tektrotyd was found only in 1 patient. This uptake was more spread and clears, comparing with accumulation in subacute stage of AMI.

Conclusion

Conclusion. Myocardium scintigraphy with 99mTc-Tektrotyd allows identifying overexpression of somatostatin receptors in areas of recent and old myocardium infarction. In some patients the radiopharmaceutical uptake may expands to a remote period of the disease. Further larger studies and histological validation of scintigraphic results are needed.

99mТс-тектротидсцинтиграфияострый инфаркт миокарда99mТс-Tektrotydscintigraphyacute myocardial infarctionReferencesTownsend N., Wilson L., Bhatnagar P., et al. Cardiovascular disease in Europe: epidemiological update 2016. Eur. Heart J. 2016; 37 (42): 3232–3245. http://doi.org/10.1093/eurheartj/ehw334Townsend N., Wilson L., Bhatnagar P., et al. Cardiovascular disease in Europe: epidemiological update 2016. Eur. Heart J. 2016; 37 (42): 3232–3245. http://doi.org/10.1093/eurheartj/ehw334Jingzhou H., Bellenger N.G., Ludman A.J. et al. Treatment of myocardial ischaemia-reperfusion injury in patients with ST-segment elevation myocardial infarction: promise, disappointment, and hope. Rev. Cardiovasc. Med. 2022; 23 (1): 23: http://doi.org/10.31083/j.rcm2301023Jingzhou H., Bellenger N.G., Ludman A.J. et al. Treatment of myocardial ischaemia-reperfusion injury in patients with ST-segment elevation myocardial infarction: promise, disappointment, and hope. Rev. Cardiovasc. Med. 2022; 23 (1): 23: http://doi.org/10.31083/j.rcm2301023Majidi M., Kosinski A.S., Al-Khatib S.M. et al. Reperfusion ventricular arrhythmia ‘bursts’ predict larger infarct size despite TIMI 3 flow restoration with primary angioplasty for anterior ST-elevation myocardial infarction. Eur. Heart J. 2009; 30: 757–764. http://doi.org/10.1093/eurheartj/ehp005Majidi M., Kosinski A.S., Al-Khatib S.M. et al. Reperfusion ventricular arrhythmia ‘bursts’ predict larger infarct size despite TIMI 3 flow restoration with primary angioplasty for anterior ST-elevation myocardial infarction. Eur. Heart J. 2009; 30: 757–764. http://doi.org/10.1093/eurheartj/ehp005Hansson G.K. Inflammation, atherosclerosis, and coronary artery disease. N. Engl. J. Med. 2005; 352 (16): 1685–1695. http://doi.org/10.1056/NEJMra043430Hansson G.K. Inflammation, atherosclerosis, and coronary artery disease. N. Engl. J. Med. 2005; 352 (16): 1685–1695. http://doi.org/10.1056/NEJMra043430Abbate A., Kontos M.Ch., Abouzaki N.A. et al. Comparative safety of interleukin-1 blockade with anakinra in patients with ST-segment elevation acute myocardial infarction (from the VCU-ART and VCU-ART2 pilot studies). Am. J. Cardiol. 2015; 115: 288–292. http://doi.org/10.1016/j.amjcard.2014.11.003Abbate A., Kontos M.Ch., Abouzaki N.A. et al. Comparative safety of interleukin-1 blockade with anakinra in patients with ST-segment elevation acute myocardial infarction (from the VCU-ART and VCU-ART2 pilot studies). Am. J. Cardiol. 2015; 115: 288–292. http://doi.org/10.1016/j.amjcard.2014.11.003Ridker P.M., Libby P., MacFadyen J.G. et al. Modulation of the interleukin-6 signalling pathway and incidence rates of atherosclerotic events and all-cause mortality: analyses from the Canakinumab Anti-Inflammatory Thrombosis Outcomes Study (CANTOS). Eur. Heart J. 2018; 38 (39): 3499–3507. http://doi.org/10.1093/eurheartj/ehy310Ridker P.M., Libby P., MacFadyen J.G. et al. Modulation of the interleukin-6 signalling pathway and incidence rates of atherosclerotic events and all-cause mortality: analyses from the Canakinumab Anti-Inflammatory Thrombosis Outcomes Study (CANTOS). Eur. Heart J. 2018; 38 (39): 3499–3507. http://doi.org/10.1093/eurheartj/ehy310Ridker P.M., Devalaraja M, Baeres F.M.M. et al. IL-6 inhibition with ziltivekimab in patients at high atherosclerotic risk (RESCUE): a double-blind, randomised, placebocontrolled, phase 2 trial. Lancet (London, England). 2021; 10289 (397): 2060–2069. https://doi.org/10.1016/S0140-6736(21)00520-1Ridker P.M., Devalaraja M, Baeres F.M.M. et al. IL-6 inhibition with ziltivekimab in patients at high atherosclerotic risk (RESCUE): a double-blind, randomised, placebocontrolled, phase 2 trial. Lancet (London, England). 2021; 10289 (397): 2060–2069. https://doi.org/10.1016/S0140-6736(21)00520-1McKnight A.H., Katzenberger D.R., Britnell S.R. Colchicine in Acute Coronary Syndrome: A Systematic Review. Ann. Pharmacother. 2021; 55 (2): 187–197. https://doi.org/10.1177/1060028020942144McKnight A.H., Katzenberger D.R., Britnell S.R. Colchicine in Acute Coronary Syndrome: A Systematic Review. Ann. Pharmacother. 2021; 55 (2): 187–197. https://doi.org/10.1177/1060028020942144Montarello1 N.J., Nguyen M.T., Wong D.T.L. et al. Inflammation in Coronary Atherosclerosis and its Therapeutic Implications. Cardiovasc. Drugs Ther. 2022; 36 (2): 347–362. https://doi.org/10.1007/s10557-020-07106-6Montarello1 N.J., Nguyen M.T., Wong D.T.L. et al. Inflammation in Coronary Atherosclerosis and its Therapeutic Implications. Cardiovasc. Drugs Ther. 2022; 36 (2): 347–362. https://doi.org/10.1007/s10557-020-07106-6Thackeray J.T. PET Assessment of Immune Cell Activity and Therapeutic Monitoring Following Myocardial Infarction. Curr. Cardiol. Rep. 2018; 20 (3): 13. https://doi.org/10.1007/s11886-018-0955-1Thackeray J.T. PET Assessment of Immune Cell Activity and Therapeutic Monitoring Following Myocardial Infarction. Curr. Cardiol. Rep. 2018; 20 (3): 13. https://doi.org/10.1007/s11886-018-0955-1Tarkin J.M., Calcagno C., Dweck M.R. et al. (68)GaDOTATATE PET identifies residual myocardial inflammation and bone marrow activation after myocardial infarction. J. Am. Coll. Cardiol. 2019; 73 (19): 2489–2491. https://doi.org/10.1016/j.jacc.2019.02.052Tarkin J.M., Calcagno C., Dweck M.R. et al. (68)GaDOTATATE PET identifies residual myocardial inflammation and bone marrow activation after myocardial infarction. J. Am. Coll. Cardiol. 2019; 73 (19): 2489–2491. https://doi.org/10.1016/j.jacc.2019.02.052Sazonova S.I., Syrkina A.G., Mochula O.V. et al. Subacute myocardial infarction detected by technetium99m-labeled somatostatin analog scintigraphy. J. Nucl. Cardiol. 2021; Apr 30. https://doi.org/10.1007/s12350-021-02644-4Sazonova S.I., Syrkina A.G., Mochula O.V. et al. Subacute myocardial infarction detected by technetium99m-labeled somatostatin analog scintigraphy. J. Nucl. Cardiol. 2021; Apr 30. https://doi.org/10.1007/s12350-021-02644-4Lapa C., Reiter T., Li X. et al. Imaging of myocardial inflammation with somatostatin receptor based PET/CT – A comparison to cardiac MRI. Int. J. Cardiol. 2015; 194: 44–49. https://doi.org/10.1016/j.ijcard.2015.05.073Lapa C., Reiter T., Li X. et al. Imaging of myocardial inflammation with somatostatin receptor based PET/CT – A comparison to cardiac MRI. Int. J. Cardiol. 2015; 194: 44–49. https://doi.org/10.1016/j.ijcard.2015.05.073Ibanez B., James S., Agewall S. et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur. Heart J. 2018; 39: 119–177. https://doi.org/10.1093/eurheartj/ehx393Ibanez B., James S., Agewall S. et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur. Heart J. 2018; 39: 119–177. https://doi.org/10.1093/eurheartj/ehx393Krenning B.J., Heiden K., Duncker D.J. et al. Nuclear Imaging of Post-infarction Inflammation in Ischemic Cardiac Diseases – New Radiotracers for Potential Clinical Applications. Curr. Radiopharm. 2021; 14 (3): 184–208. https://doi.org/10.2174/1874471013666201012165305Krenning B.J., Heiden K., Duncker D.J. et al. Nuclear Imaging of Post-infarction Inflammation in Ischemic Cardiac Diseases – New Radiotracers for Potential Clinical Applications. Curr. Radiopharm. 2021; 14 (3): 184–208. https://doi.org/10.2174/1874471013666201012165305Hyafil F., Gimelli A., Slart R. et al. EANM procedural guidelines for myocardial perfusion scintigraphy using cardiac-centered gamma cameras. Eur. J. Hybrid Imaging. 2019; 3 (1): 11. https://doi.org/10.1186/s41824-019-0058-2Hyafil F., Gimelli A., Slart R. et al. EANM procedural guidelines for myocardial perfusion scintigraphy using cardiac-centered gamma cameras. Eur. J. Hybrid Imaging. 2019; 3 (1): 11. https://doi.org/10.1186/s41824-019-0058-2Pazhenkottil A.P., Ghadri J.R., Nkoulou R.N. et al. Improved outcome prediction by SPECT myocardial perfusion imaging after CT attenuation correction. J. Nucl. Med. 2011; 52 (2): 196–200. https://doi.org/10.2967/jnumed.110.080580Pazhenkottil A.P., Ghadri J.R., Nkoulou R.N. et al. Improved outcome prediction by SPECT myocardial perfusion imaging after CT attenuation correction. J. Nucl. Med. 2011; 52 (2): 196–200. https://doi.org/10.2967/jnumed.110.080580Hachamovitch R., Kang X., Amanullah A.M. et al. Prognostic implications of myocardial perfusion singlephoton emission computed tomography in the elderly. Circulation. 2009; 120 (22): 2197–2206. https://doi.org/10.1161/CIRCULATIONAHA.108.817387Hachamovitch R., Kang X., Amanullah A.M. et al. Prognostic implications of myocardial perfusion singlephoton emission computed tomography in the elderly. Circulation. 2009; 120 (22): 2197–2206. https://doi.org/10.1161/CIRCULATIONAHA.108.817387Thackeray J.T., Bankstahl J.P., Wang Y. et al. Targeting post-infarct inflammation by PET imaging: comparison of 68 Ga-citrate and 68Ga-DOTATATE with 18 F-FDG in a mouse model. Eur. J. Nucl. Med. Mol. Imaging. 2014; 42: 317–27. https://doi.org/10.1007/s00259-014-2884-6Thackeray J.T., Bankstahl J.P., Wang Y. et al. Targeting post-infarct inflammation by PET imaging: comparison of 68 Ga-citrate and 68Ga-DOTATATE with 18 F-FDG in a mouse model. Eur. J. Nucl. Med. Mol. Imaging. 2014; 42: 317–27. https://doi.org/10.1007/s00259-014-2884-6

The authors declare that there are no conflicts of interest present.