Dual radionuclide study of myocardial infarction. Relationships between myocardial uptake of potassium-43, technetium-99m stannous pyrophosphate, regional myocardial blood flow, and creatine phosphorokinase depletion

Journal Article · Sun Feb 29 23:00:00 EST 1976 · Circulation; (United States)

DOI:https://doi.org/10.1161/01.CIR.53.3.422· OSTI ID:7334036

Zaret, B L; DiCola, V C; Donabedian, R K; Puri, S; Wolfson, S; Freedman, G S; Cohen, L S

The dual radionuclide myocardial distributions of imaging agents potassium-43 (/sup 43/K) and technetium-99m stannous pyrophosphate (/sup 99m/Tc-PYP) were studied in a 24-hour closed chest canine infarct preparation. In multiple myocardial biopsies in 20 dogs, tissue levels of both radionuclides were compared to either an index of tissue viability (myocardial creatine phosphokinase (CPK) depletion), or to estimates of regional myocardial blood flow as measured by the microsphere technique. Myocardial /sup 43/K uptake in the ischemic and infarcted zone correlated well with both CPK depletion (r = 0.73) and microsphere estimates of relative blood flow. The correlation with microspheres was excellent in the transmural sample (r = 0.93) as well as endocardial (r = 0.97) and epicardial (r = 0.86) portions. On the other hand, /sup 99m/Tc-PYP myocardial uptake did not correlate with the extent of CPK depletion. Maximal uptake was frequently noted in border zones with only moderate CPK depletion, while lesser degrees of /sup 99m/Tc-PYP uptake were noted in the central infarct zone where CPK activity was lowest. The relationship of /sup 99m/Tc-PYP uptake to microsphere regional flow estimates demonstrated that /sup 99m/Tc-PYP uptake was maximal at flows of 0.3 to 0.4 of normal. At lower flows, /sup 99m/Tc-PYP uptake fell toward normal levels. A similar relationship was noted between the distributions of /sup 99m/Tc-PYP and /sup 43/K. In relatively high flow border segments (greater than or equal to 0.80 of normal), abnormal /sup 99m/Tc-PYP uptake of five to six times normal persisted. The transmural distribution of /sup 99m/Tc-PYP demonstrated that in low flow regions /sup 99m/Tc-PYP uptake was primarily epicardial, while in the higher flow ischemic periphery of the infarct endocardial uptake predominated.

• Research Organization: Yale Univ., New Haven
• OSTI ID: 7334036
• Journal Information: Circulation; (United States), Journal Name: Circulation; (United States) Vol. 53:3; ISSN CIRCA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ALKALI METAL ISOTOPES
ANIMALS
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BLOOD FLOW
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
DOGS
HEART
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MAMMALS
MEASURING METHODS
MUSCLES
MYOCARDIAL INFARCTION
MYOCARDIUM
NUCLEI
ODD-EVEN NUCLEI
ORGANS
POTASSIUM 43
POTASSIUM ISOTOPES
RADIOISOTOPE SCANNING
RADIOISOTOPES
SCINTISCANNING
TECHNETIUM 99
TECHNETIUM ISOTOPES
VERTEBRATES
YEARS LIVING RADIOISOTOPES