Temporal dependence of beneficial effects of coronary thrombolysis characterized by positron tomography

Journal Article · Fri Oct 01 04:00:00 EDT 1982 · Am. J. Med.; (United States)

DOI:https://doi.org/10.1016/0002-9343(82)90338-2· OSTI ID:6584601

Bergmann, S R; Lerch, R A; Fox, K A; Ludbrook, P A; Welch, M J; Ter-Pogossian, M M; Sobel, B E

To delineate beneficial effects of intracoronary thrombolysis on myocardial metabolism in vivo and their dependence on the interval after coronary occlusion prior to reperfusion, we studied 23 closed-chest dogs. Coronary occlusion was produced with a thrombogenic copper coil to performance of cardiac positron emission tomography with /sup 11/C-palmitate. Jeopardized zones were calculated by summation by myocardial regions exhibiting less than 50 percent of the peak left ventricular wall radioactivity, and residual metabolic activity within jeopardized zones quantified based on the average counts compared with average counts in normal myocardium. After tomography, streptokinase was infused into the coronary artery (4,000 units per minute), resulting in angiographically demonstrable restoration of patency. Repeat tomography performed 90 minutes after the initial study with a second injection of /sup 11/C-palmitate demonstrated reduction of jeopardized zones by 51 +/- 6.3 percent (SE) and by 21 +/- 1.8 (p less than 0.01 based on paired comparisons) when refusion was initiated 1 to 2 (in four dogs) or 2 to 4 (in six dogs) hours after occlusion. Metabolic activity in initially jeopardized regions increased by 111 +/- 24.3 percent and 61.8 +/- 12.6 (p less than 0.01 for each). When streptokinase was infused later after occlusion, significant salutary metabolic effects did not occur. These results indicate that positron tomography may be useful in the clinical delineation of the efficacy of thrombolytic therapy in restoring myocardial metabolism and underscore the marked dependence of such efficacy on the duration of the interval of ischemia prior to the onset of reperfusion.

• Research Organization: Cardiovascular Division of the Department of Internal Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
• OSTI ID: 6584601
• Journal Information: Am. J. Med.; (United States), Journal Name: Am. J. Med.; (United States) Vol. 73:4; ISSN AJMEA
• Country of Publication: United States
• Language: English

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550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ANIMALS
ARTERIES
BETA DECAY RADIOISOTOPES
BETA-PLUS DECAY RADIOISOTOPES
BLOOD VESSELS
BODY
CARBON 11
CARBON ISOTOPES
CARBOXYLIC ACIDS
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COMPUTERIZED TOMOGRAPHY
CORONARIES
DIAGNOSTIC TECHNIQUES
DISEASES
DOGS
DRUGS
EMISSION COMPUTED TOMOGRAPHY
ENZYMES
EVEN-ODD NUCLEI
HEART
HEXADECANOIC ACID
HYDROLASES
IN VIVO
ISCHEMIA
ISOTOPES
LABELLED COMPOUNDS
LIGHT NUCLEI
MAMMALS
METABOLISM
MINUTES LIVING RADIOISOTOPES
MONOCARBOXYLIC ACIDS
MUSCLES
MYOCARDIUM
NUCLEI
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANS
PEPTIDE HYDROLASES
POSITRON COMPUTED TOMOGRAPHY
RADIOISOTOPES
RADIOPHARMACEUTICALS
SH-PROTEINASES
STREPTOCOCCAL PROTEINASE
TIME DEPENDENCE
TOMOGRAPHY
VASCULAR DISEASES
VERTEBRATES