title: Diagnosis of acute myocardial infarction by indium-111 antimyosin antibodies and correlation with the traditional techniques for the evaluation of extent and localization.
abstract: This clinical study evaluated the accuracy of planar myocardial scintigraphy with antimyosin monoclonal antibodies radiolabeled with indium-111 (AMA-Fab) in the detection and localization of acute myocardial infarction (AMI). Fifty-seven patients admitted for suspected AMI were studied; 17 patients underwent thrombolytic therapy with intravenous streptokinase and 11 had clinical signs of reperfusion; 9 had had a previous myocardial infarction. Fifty of 57 patients were discharged from the coronary care unit with a confirmed diagnosis of AMI. The AMA-Fab study results were positive for AMI in 49 patients (98%) and negative in 1 (2%). Among the 7 patients without AMI, 5 had unstable angina, 1 had Prinzmetal's variant angina and 1 had acute pancreatitis. AMA-Fab results were negative in 6 of 7 patients (85%) and positive in 1 (15%). Therefore, the sensitivity and specificity of AMA-Fab scintigraphy were 0.98 and 0.85, respectively. To assess accuracy in defining the extent and location of AMI, AMA-Fab results were compared with those of the electrocardiogram, echocardiogram, technetium-99m pyrophosphate myocardial scintigraphy and coronary angiography and left ventriculography. AMA-Fab scintigraphy showed a good concordance with the traditional techniques in the topographic definition of the infarcted regions. No uptake of AMA-Fab was seen in the regions of previous old infarcts. Ten healthy volunteers also underwent AMA-Fab scintigraphy. No evidence of myocardial tracer uptake was noted in them. No adverse reactions or side effects were noted after injection of AMA-Fab in any patient. It is concluded that planar myocardial scintigraphy with AMA-Fab is a reliable method for AMI detection and location.
authors.affiliation: Cattedra di Cardiologia, University of Brescia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Volpini
authors.forename: R
authors.initials: R
authors.lastname: Giubbini
authors.forename: P
authors.initials: P
authors.lastname: Gei
authors.forename: C
authors.initials: C
authors.lastname: Cuccia
authors.forename: P
authors.initials: P
authors.lastname: Franzoni
authors.forename: S
authors.initials: S
authors.lastname: Riva
authors.forename: A
authors.initials: A
authors.lastname: Terzi
authors.forename: M
authors.initials: M
authors.lastname: Metra
authors.forename: M
authors.initials: M
authors.lastname: Bestagno
authors.forename: O
authors.initials: O
authors.lastname: Visioli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal; D011756:Diphosphates; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D007128:Immunoglobulin Fragments; D007205:Indium Radioisotopes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000000981:diagnostic imaging*; D009218:Myosins / Q000276:immunology*; D011877:Radionuclide Imaging; D013667:Technetium; D016698:Technetium Tc 99m Pyrophosphate
chemical_list: D000911:Antibodies, Monoclonal; D011756:Diphosphates; D007128:Immunoglobulin Fragments; D007205:Indium Radioisotopes; D016698:Technetium Tc 99m Pyrophosphate; D013667:Technetium; D009218:Myosins