Serial changes in myocardial perfusion using tomographic technetium-99m-hexakis-2-methoxy-2-methylpropyl-isonitrile imaging following reperfusion therapy of myocardial infarction.
Resting tomographic myocardial perfusion images using technetium-99m-hexakis-2-methoxy-2-methylpropyl-isonitrile (Tc-Sestamibi) were obtained in 25 patients during their first myocardial infarction. Tc-Sestamibi was injected intravenously before acute reperfusion therapy, and repeated twice, at 18-48 hr, and at 6 to 14 days. Reperfusion was successful in 19 patients. In the patients with successful reperfusion, there was a mean decrease in the amount of hypoperfused myocardium between the initial and second studies (-9% +/- 12%, p = 0.004) and a further decrease between the second and final studies (-10% +/- 12%, p = 0.002). Nine of these 19 patients (47%) had evidence of significant improvement at the time of the second study. In six patients, significant improvement was not evident until the final study. Although tomographic imaging with Tc-Sestamibi following reperfusion therapy may show improvement in perfusion at 18-48 hr, the full extent of improvement is usually not evident until later.
Pellikka
P A
PA
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905.
Behrenbeck
T
T
Verani
M S
MS
Mahmarian
J J
JJ
Wackers
F J
FJ
Gibbons
R J
RJ
D000328:Adult; D000368:Aged; D003326:Coronary Circulation; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D015425:Myocardial Reperfusion; D009570:Nitriles; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D017256:Technetium Tc 99m Sestamibi; D013997:Time Factors
D009570:Nitriles; D015609:Organotechnetium Compounds; D017256:Technetium Tc 99m Sestamibi