Use of thallium-201 redistribution scintigraphy in the preoperative differentiation of reversible and nonreversible myocardial asynergy
Thallium-201 (/sup 201/Tl) redistribution scintigraphy might differentiate reversibly from nonreversibly asynergic myocardial segments and thus predict the response of these segments to coronary artery bypass grafting (CABG). To test this hypothesis, 25 consecutive patients undergoing CABG, preoperative stress-redistribution /sup 201/Tl scintigraphy, and both pre- and postoperative resting equilibrium radionuclide ventriculography were evaluated. For both types of scintigraphic study, each patient was imaged in the same three views. Because of the effects of CABG on septal motion, this region was considered separately. Postoperative improvement was noted in 54% of 72 preoperative asynergic segments. Improvement was common not only in hypokinetic but also in akinetic and dyskinetic segments, and occurred in a similar proportion of studies performed early (less than 2 weeks) or late (3-6 months) after CABG. Thallium-201 redistribution scintigraphy was highly predictive of the pattern of postoperative asynergy: The redistribution pattern was normal in 90% of segments with reversible asynergy and abnormal in 76% of segments with nonreversible asynergy. The presence or absence of pathologic Q waves was less sensitive in this differentiation. Septal segments, however, frequently demonstrated abnormal wall motion postoperatively, despite normal /sup 201/Tl redistribution scintigraphy. Resting left ventricular ejection fraction (LVEF) was generally unchanged postoperatively, but in some patients with multiple areas of reversible asynergy it did improve. Thus, /sup 201/Tl redistribution scintigraphy appears to reliably distinguish viable from nonviable asynergic myocardial zones, and predicts the response of these segments to CABG.
- Research Organization:
- Department of Nuclear Medicine, Cedars-Sinai Medical Center
- OSTI ID:
- 5478937
- Journal Information:
- Circulation; (United States), Journal Name: Circulation; (United States) Vol. 64:5; ISSN CIRCA
- Country of Publication:
- United States
- Language:
- English
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560171 -- Radiation Effects-- Nuclide Kinetics & Toxicology-- Man-- (-1987)
62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
BETA DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DIAGRAMS
ELECTROCARDIOGRAMS
ELECTRON CAPTURE RADIOISOTOPES
HEART
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MUSCLES
MYOCARDIUM
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATIENTS
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIONUCLIDE KINETICS
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
THALLIUM 201
THALLIUM ISOTOPES