Effect of infarct size measured from antimyosin single-photon emission computed tomographic scans on left ventricular remodeling.
To evaluate the effect of infarct size on left ventricular volumes and geometric remodeling, 26 patients with a first acute Q wave myocardial infarction (anterior in 14, inferior in 12) had the infarct sized from single-photon emission computed tomographic (SPECT) imaging of indium-111 antimyosin. All patients underwent gated blood pool scintigraphy before hospital discharge for determination of ejection fraction and end-diastolic and end-systolic volume indexes. Infarct size was quantitated from indium-111 antimyosin uptake in coronal slices with use of a threshold technique for edge detection. Nineteen of 26 patients had additional simultaneous acquisitions of indium-111 and thallium-201 uptake and the infarct was expressed as a percent of the total left ventricle. Infarct size was larger (59 +/- 16 vs. 33 +/- 16 g), predischarge ejection fraction lower (35 +/- 5% vs. 60 +/- 9%) and end-systolic volume index higher (57 +/- 13 vs. 36 +/- 10 ml/m2) in the group with anterior infarction. Despite these differences, predischarge end-diastolic volume index was not significantly different between the group with anterior (88 +/- 17 ml/m2) versus inferior (89 +/- 14 ml/m2) infarction. There was a significant inverse correlation between percent infarct size and ejection fraction for patients with dual isotope imaging (r = -0.90) and a significant direct correlation between infarct size and end-systolic volume index (r = 0.79, p less than 0.01). Fourteen patients without subsequent myocardial infarction or coronary artery bypass grafting had a repeat gated blood pool study late (26 +/- 15 months) after infarction.(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Medicine, Columbia University, New York, New York 10032.
M L
ML
Antunes
M E
ME
Tresgallo
D W
DW
Seldin
K
K
Bhatia
L L
LL
Johnson
D000328:Adult; D000368:Aged; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D015637:Gated Blood-Pool Imaging; D006801:Humans; D007205:Indium Radioisotopes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D012307:Risk Factors; D013314:Stress, Mechanical; D013318:Stroke Volume / Q000502:physiology; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon; D016277:Ventricular Function, Left / Q000502:physiology*
D007205:Indium Radioisotopes; D013794:Thallium Radioisotopes