99mTc-MIBI washout rate as a marker of myocardial mitochondrial dysfunction; a systematic review and meta-analysis

Abstract

The systemic review and metaanalysis describes the features of the 99mTc-MIBI pharmacokinetics, which make it possible to assess mitochondrial myocardial dysfunction in vivo, and also shows the main clinical application points the phenomenon of accelerated 99mTc-MIBI washout rate. The study of foreign and domestic literature described the informativeness of the reverse redistribution phenomenon and the 99mTc-MIBI washout rate as a marker of mitochondrial myocardial dysfunction was carried out. The analysis included publications selected by the following keywords and their combinations: mitochondrial dysfunction, 99mTc-MIBI, 99mTc-Tetrofosmin, myocardial perfusion scintigraphy, reverse redistribution, washout rate. A total of 17 publications have been collected for a systematic review of clinical studies in the field of studying and evaluating mitochondrial dysfunction according to myocardial perfusion scintigraphy. 6 studies with a case-control design were selected to perform the metaanalysis. An analysis of the literature shows that the severity of the reverse redistribution phenomenon and 99mTc-MIBI washout rate are associated with the microstructure of mitochondria and myocardium, contractility and hemodynamics of the left ventricle, the level of natriuretic peptides, exercise tolerance, severity of coronary atherosclerosis, oxidative metabolism of the myocardium, the risk of cardiovascular events. According to the data of the meta-analysis, it was found that the rate of washout rate was statistically significantly accelerated in patients with heart pathology, as compared to the control. Thus, the assessment of mitochondrial function by 99mTc-MIBI washout assessment can provide additional information about the functional state of the myocardium.