Role of myocardial perfusion imaging in evaluating thrombolytic therapy for acute myocardial infarction

Journal Article · Sun Mar 01 00:00:00 EST 1987 · J. Am. Coll. Cardiol.; (United States)

DOI:https://doi.org/10.1016/S0735-1097(87)80062-1· OSTI ID:6593159

Beller, G A

Myocardial thallium-201 scintigraphy is being increasingly employed as a method for assessing the efficacy of coronary reperfusion in acute myocardial infarction. New thallium uptake after intracoronary tracer administration after successful recanalization indicates that nutrient blood flow has been successfully restored. One may also presume that some myocardial salvage occurred if thallium administered in this manner is transported intracellularly by myocytes with intact sarcolemmal membranes. However, if one injects thallium by way of the intracoronary route immediately after reperfusion, the initial uptake of thallium in reperfused myocardium may predominantly represent hyperemic flow and regional thallium counts measured may not be proportional to the mass of viable myocytes. When thallium is injected intravenously during the occlusion phase the degree of redistribution after thrombolysis is proportional to the degree of flow restoration and myocardial viability. When thallium is injected for the first time intravenously immediately after reperfusion, an overestimation of myocardial salvage may occur because of excess thallium uptake in the infarct zone consequent to significant hyperemia. Another approach to myocardial thallium scintigraphy in patients undergoing thrombolytic therapy is to administer two separate intravenous injections before and 24 hours or later after treatment. Finally, patients with acute myocardial infarction who receive intravenous thrombolytic therapy are candidates for predischarge exercise thallium-201 scintigraphy for risk stratification and detection of residual ischemia.

• Research Organization: Univ. of Virginia Medical Center, Charlottesville
• OSTI ID: 6593159
• Journal Information: J. Am. Coll. Cardiol.; (United States), Vol. 3
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
MYOCARDIAL INFARCTION
BLOOD FLOW
CHEMOTHERAPY
MYOCARDIUM
SCINTISCANNING
DIAGNOSIS
FIBRINOLYTIC AGENTS
HEART
PERFUSED ORGANS
THALLIUM 201
BETA DECAY RADIOISOTOPES
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
MUSCLES
NUCLEI
ODD-EVEN NUCLEI
ORGANS
RADIOISOTOPE SCANNING
RADIOISOTOPES
SECONDS LIVING RADIOISOTOPES
THALLIUM ISOTOPES
THERAPY
550601* - Medicine- Unsealed Radionuclides in Diagnostics