Thrombolysis in acute myocardial infarction using intracoronary streptokinase: assessment by /sup 201/Tl scintigraphy

Journal Article · Wed Sep 01 00:00:00 EDT 1982 · Circulation; (United States)

DOI:https://doi.org/10.1161/01.CIR.66.3.658· OSTI ID:6705840

Schuler, G; Schwarz, F; Hofmann, M; Mehmel, H; Manthey, J; Maeurer, W; Rauch, B; Herrmann, H J; Kuebler, W

Twenty-one patients with acute myocardial infarction, admitted to the hospital within 4 hours after the onset of symptoms, were studied by seven-pinhole /sup 201/Tl scintigraphy before and 1 hour and 24 hours after intracoronary fibrinolysis using streptokinase. The size of the /sup 201/Tl perfusion defect was assessed from myocardial cross sections reconstructed from the original seven-pinhole data and expressed as a fraction of left ventricular circumference. Recanalization was achieved in 16 patients within 3.9 +/- 1.6 hours after onset of symptoms (group A). In these patients, the size of the perfusion defect had decreased from 36 +/- 17% to 19% +/- 15% (p less than 0.001) at 24 hours. No significant change was detected by redistribution at 1 hour after the intervention. In five patients, intracoronary fibrinolysis was unsuccessful, and the vessel remained occluded (group B). The /sup 201/Tl perfusion defect affected 40 +/- 15% of the left ventricular circumference before the intervention; it remained virtually unchanged at 1 hour (37 +/- 16%) and at 24 hours (41 +/- 15%) after fibrinolysis. The perfusion defect was most reduced in patients with extensive collaterals supplying the ischemic area or with subtotal occlusion of the affected coronary artery. We conclude that successful intracoronary fibrinolysis may reduce the size of the /sup 201/Tl perfusion defect in many patients with acute myocardial infarction. One important factor in the final result may be the presence of residual coronary flow supplied by extensive collaterals or by subtotal occlusion of the affected coronary artery when reperfusion is achieved around 4 hours after the onset of symptoms.

• Research Organization: Medizinische Universitaetsklinik, Abteilung Innere Medizine III (Cardiologie), Heidelberg, West Germany
• OSTI ID: 6705840
• Journal Information: Circulation; (United States), Vol. 66:3
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
59 BASIC BIOLOGICAL SCIENCES
MYOCARDIAL INFARCTION
PATHOLOGY
MYOCARDIUM
SCINTISCANNING
THALLIUM 201
DIAGNOSTIC USES
CORONARIES
FIBRINOLYSIS
PATIENTS
STREPTOCOCCAL PROTEINASE
ARTERIES
BETA DECAY RADIOISOTOPES
BLOOD VESSELS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CHEMICAL REACTIONS
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DECOMPOSITION
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
ENZYMES
HEART
HEAVY NUCLEI
HYDROLASES
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MUSCLES
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PEPTIDE HYDROLASES
PROTEOLYSIS
RADIOISOTOPE SCANNING
RADIOISOTOPES
SECONDS LIVING RADIOISOTOPES
SH-PROTEINASES
THALLIUM ISOTOPES
USES
550601* - Medicine- Unsealed Radionuclides in Diagnostics
550901 - Pathology- Tracer Techniques