Comparison of indium-111 antimyosin antibody and technetium-99m pyrophosphate localization in reperfused and nonreperfused myocardial infarction.
Recent imaging studies suggest that technetium-99m (Tc-99m) pyrophosphate yields a considerably larger estimate of myocardial infarct size than does indium-111 (In-111) monoclonal antimyosin antibody. To determine whether Tc-99m pyrophosphate may be taken up by reversibly injured myocytes, particularly in the setting of coronary reperfusion, the tissue localization of Tc-99m pyrophosphate and antimyosin antibody was compared in 11 dogs 24 to 68 h after anterior descending coronary artery occlusion (4 dogs with permanent occlusion, 7 with reperfusion). Technetium-99m pyrophosphate and In-111 antimyosin antibody content was determined in serial 2 to 3 mm wide endocardial and epicardial samples taken through the infarct zone in multiple short-axis left ventricular slices. The number of samples with increased In-111 antimyosin antibody (defined as greater than or equal to mean + 2 SD of normal) was not significantly different from that with increased Tc-99m pyrophosphate. This was true in both reperfused and nonreperfused infarcts. However, the intensity of uptake of Tc-99m pyrophosphate exceeded that of In-111 antimyosin antibody, particularly in the border zones of reperfused infarcts, and the area with moderate to marked increase in tracer uptake (greater than or equal to 2 times normal) was significantly larger with Tc-99m pyrophosphate than In-111 antimyosin antibody (p less than 0.001). A specific zone of abnormal Tc-99m pyrophosphate with normal In-111 antimyosin antibody content could not be identified. Histologic evidence of myocardial necrosis was found in virtually every sample with increased In-111 antimyosin antibody, Tc-99m pyrophosphate, or both.(ABSTRACT TRUNCATED AT 250 WORDS)
Takeda
K
K
Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland.
LaFrance
N D
ND
Weisman
H F
HF
Wagner
H N
HN
Becker
L C
LC
D000818:Animals; D000911:Antibodies, Monoclonal; D011756:Diphosphates; D004285:Dogs; D005260:Female; D007205:Indium Radioisotopes; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D015425:Myocardial Reperfusion; D009942:Organometallic Compounds; D011877:Radionuclide Imaging; D013667:Technetium; D016698:Technetium Tc 99m Pyrophosphate
D000911:Antibodies, Monoclonal; D011756:Diphosphates; D007205:Indium Radioisotopes; D009942:Organometallic Compounds; C058899:imciromab pentetate; D016698:Technetium Tc 99m Pyrophosphate; D013667:Technetium