Thrombolysis in acute myocardial infarction using intracoronary streptokinase: assessment by thallium-201 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:6097280

Schuler, G; Schwarz, F; Hofmann, M; Mehmel, H; Manthey, J; Maurer, W; Rauch, B; Herrmann, H; Kubler, 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 thallium-201 scintigraphy before and 1 hour and 24 hours after intracoronary fibrinolysis using streptokinase. The size of the thallium-201 perfusion defect was assessed from myocardial cross sections reconstructed from the riginal 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<0.001) at 24 hours. No significant change was detected to redistribution at 1 hour after the intervention. In five patients, intracoronary fibrinolysis was unsuccessful, and the vessel remained occluded (group B). The thallium-201 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. It is concluded that successful intracoronary fibrinolysis may reduce the size of the thallium-201 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 Universitatsklinik, Heidelberg, West Germany
• OSTI ID: 6097280
• Journal Information: Circulation; (United States), Journal Name: Circulation; (United States) Vol. 66:3; ISSN CIRCA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CHEMICAL REACTIONS
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DECOMPOSITION
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
ENZYMES
FIBRINOLYSIS
HEART
HEAVY NUCLEI
HYDROLASES
ISOMERIC TRANSITION ISOTOPES
ISOTOPE APPLICATIONS
ISOTOPES
LABELLED COMPOUNDS
MUSCLES
MYOCARDIUM
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATIENTS
PEPTIDE HYDROLASES
PERFUSED ORGANS
PROTEOLYSIS
RADIOISOTOPE SCANNING
RADIOISOTOPES
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
SH-PROTEINASES
STREPTOCOCCAL PROTEINASE
THALLIUM 201
THALLIUM ISOTOPES
TRACER TECHNIQUES