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Title: Intracoronary thallium-201 scintigraphy after thrombolytic therapy for acute myocardial infarction compared with 10 and 100 day intravenous thallium-201 scintigraphy

Abstract

Thallium-201 imaging has been utilized to estimate myocardial salvage after thrombolytic therapy for acute myocardial infarction. However, results from recent animal studies have suggested that as a result of reactive hyperemia and delayed necrosis, thallium-201 imaging may overestimate myocardial salvage. To determine whether early overestimation of salvage occurs in humans, intracoronary thallium-201 scans 1 hour after thrombolytic therapy were compared with intravenous thallium-201 scans obtained approximately 10 and 100 days after myocardial infarction in 29 patients. In 10 patients with angiographic evidence of coronary reperfusion, immediate improvement in thallium defects and no interim clinical events, there was no change in imaging in the follow-up studies. Of nine patients with coronary reperfusion but no initial improvement of perfusion defects, none showed worsening of defects in the follow-up images. Six of these patients demonstrated subsequent improvement at either 10 or 100 days after infarction. Seven of 10 patients with neither early evidence of reperfusion nor improvement in perfusion defects had improvement of infarct-related perfusion defects, and none showed worsening. In conclusion, serial scanning at 10 and 100 days after infarction in patients with no subsequent clinical events showed no worsening of the perfusion image compared with images obtained in acute studies. Therefore,more » there is no evidence that thallium-201 imaging performed early in patients with acute myocardial infarction overestimates improvement.« less

Authors:
; ; ; ; ; ; ;
Publication Date:
Research Org.:
Charles A. Dana Research Institute, Boston, MA
OSTI Identifier:
6708475
Alternate Identifier(s):
OSTI ID: 6708475
Resource Type:
Journal Article
Journal Name:
J. Am. Coll. Cardiol.; (United States)
Additional Journal Information:
Journal Volume: 2
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CORONARIES; SCINTISCANNING; DIAGNOSIS; FIBRINOLYTIC AGENTS; HEART; MYOCARDIAL INFARCTION; PATIENTS; THALLIUM 201; ARTERIES; BETA DECAY RADIOISOTOPES; BLOOD VESSELS; BODY; CARDIOVASCULAR DISEASES; CARDIOVASCULAR SYSTEM; COUNTING TECHNIQUES; DAYS LIVING RADIOISOTOPES; DIAGNOSTIC TECHNIQUES; DISEASES; DRUGS; ELECTRON CAPTURE RADIOISOTOPES; HEAVY NUCLEI; HEMATOLOGIC AGENTS; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; NUCLEI; ODD-EVEN NUCLEI; ORGANS; RADIOISOTOPE SCANNING; RADIOISOTOPES; SECONDS LIVING RADIOISOTOPES; THALLIUM ISOTOPES 550601* -- Medicine-- Unsealed Radionuclides in Diagnostics

Citation Formats

Heller, G.V., Parker, J.A., Silverman, K.J., Royal, H.D., Kolodny, G.M., Paulin, S., Braunwald, E., and Markis, J.E. Intracoronary thallium-201 scintigraphy after thrombolytic therapy for acute myocardial infarction compared with 10 and 100 day intravenous thallium-201 scintigraphy. United States: N. p., 1987. Web. doi:10.1016/S0735-1097(87)80379-0.
Heller, G.V., Parker, J.A., Silverman, K.J., Royal, H.D., Kolodny, G.M., Paulin, S., Braunwald, E., & Markis, J.E. Intracoronary thallium-201 scintigraphy after thrombolytic therapy for acute myocardial infarction compared with 10 and 100 day intravenous thallium-201 scintigraphy. United States. doi:10.1016/S0735-1097(87)80379-0.
Heller, G.V., Parker, J.A., Silverman, K.J., Royal, H.D., Kolodny, G.M., Paulin, S., Braunwald, E., and Markis, J.E. Sun . "Intracoronary thallium-201 scintigraphy after thrombolytic therapy for acute myocardial infarction compared with 10 and 100 day intravenous thallium-201 scintigraphy". United States. doi:10.1016/S0735-1097(87)80379-0.
@article{osti_6708475,
title = {Intracoronary thallium-201 scintigraphy after thrombolytic therapy for acute myocardial infarction compared with 10 and 100 day intravenous thallium-201 scintigraphy},
author = {Heller, G.V. and Parker, J.A. and Silverman, K.J. and Royal, H.D. and Kolodny, G.M. and Paulin, S. and Braunwald, E. and Markis, J.E.},
abstractNote = {Thallium-201 imaging has been utilized to estimate myocardial salvage after thrombolytic therapy for acute myocardial infarction. However, results from recent animal studies have suggested that as a result of reactive hyperemia and delayed necrosis, thallium-201 imaging may overestimate myocardial salvage. To determine whether early overestimation of salvage occurs in humans, intracoronary thallium-201 scans 1 hour after thrombolytic therapy were compared with intravenous thallium-201 scans obtained approximately 10 and 100 days after myocardial infarction in 29 patients. In 10 patients with angiographic evidence of coronary reperfusion, immediate improvement in thallium defects and no interim clinical events, there was no change in imaging in the follow-up studies. Of nine patients with coronary reperfusion but no initial improvement of perfusion defects, none showed worsening of defects in the follow-up images. Six of these patients demonstrated subsequent improvement at either 10 or 100 days after infarction. Seven of 10 patients with neither early evidence of reperfusion nor improvement in perfusion defects had improvement of infarct-related perfusion defects, and none showed worsening. In conclusion, serial scanning at 10 and 100 days after infarction in patients with no subsequent clinical events showed no worsening of the perfusion image compared with images obtained in acute studies. Therefore, there is no evidence that thallium-201 imaging performed early in patients with acute myocardial infarction overestimates improvement.},
doi = {10.1016/S0735-1097(87)80379-0},
journal = {J. Am. Coll. Cardiol.; (United States)},
number = ,
volume = 2,
place = {United States},
year = {1987},
month = {2}
}