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Clinical estimation of acute myocardial infarct size with /sup 99m/technetium pyrophosphate scintigraphy

Journal Article · · Circulation; (United States)
We evaluated scintigraphic techniques in estimating infarct size. In 26 patients with acute transmural myocardial infarction, /sup 99m/Technetium pyrophosphate (TcPYP) infarct scintigraphy, gated cardiac blood pool scintigraphy and 201-Thallium (201-Tl) perfusion scintigraphy were performed. Invasive hemodynamic measurements were obtained and serial venous blood specimens taken for measurement of total and MB creatine phosphokinase (CPK). Infarct size was estimated from the area of abnormal TcPYP uptake, the extent of reduced 101-Tl uptake, the percentage of abnormally contracting segments, and serial enzyme measurements. Left ventricular ejection fraction (LVEF) and stroke work index (LVSWI) were calculated. TcPYP infarct area was associated with the extent of reduced 201-Tl uptake (r = 0.66), the percentage of abnormally contracting segments (r = 0.64), and with both LVSWI (r = 0.73) and LVEF (r = -0.58). TcPYP infarct area did not correlate with cumulative total or MB-CPK release or the integrated total CPK-time curve, nor did the enzyme estimates of infarct size correlate with LVSWI or LVEF. Variable perfusion of infarcts of different sizes may explain the lack of correlation between TcPYP infarct area and enzyme estimates of infarct size. A combination of anatomic and functional indices derived from scintigraphic and hemodynamic measurements may provide the best assessment of infarct size.
Research Organization:
Univ. of California, San Francisco
OSTI ID:
5115395
Journal Information:
Circulation; (United States), Journal Name: Circulation; (United States) Vol. 57:2; ISSN CIRCA
Country of Publication:
United States
Language:
English

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