[Myocardial perfusion with 201-thallium tomography in the post-infarct phase: prognostic significance and 1-year follow-up].
An individualized post-infarction risk stratification has impact on therapeutic decision making and prognosis after acute myocardial infarction. For evaluation of the cardiac risk profile 80 consecutive post-infarction patients were subjected to biphasic thallium-201 tomography after dipyridamole infusion for maximal coronary vasodilation. By correlating the extent and localization of reversible and irreversible perfusion defects with coronary angiography and one-year follow-up data of 94% of the patients, several univariate parameters with prognostic implications for a risk profile were identified. A stepwise logistic regression model selected the combination of 1) an irreversible defect of greater than 30% of left ventricular myocardium with less than 25% redistribution in the total defect, and 2) a reversible defect of greater than 6% of myocardium with 25% redistribution in the total defect to give optimal sensitivity of 100% and a specificity of 97% for cardiac events such as recurrence of angina, reinfarction, interventional coronary revascularization, and death within one year post infarction. Thus, the semiquantitative tomographic analysis of post-infarction myocardial perfusion allows an efficient individual risk stratification with a non-invasive technique.
Nienaber
C A
CA
Division of Nuclear Medicine & Biophysics, UCLA School of Medicine.
Salge
D
D
Spielmann
R P
RP
Bleifeld
W
W
D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D004176:Dipyridamole; D004562:Electrocardiography; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000401:mortality; D011379:Prognosis; D012307:Risk Factors; D013794:Thallium Radioisotopes; D014055:Tomography, Emission-Computed
D013794:Thallium Radioisotopes; D004176:Dipyridamole
Myokardperfusion mit 201-Thallium-Tomographie in der Postinfarktphase: Prognostische Bedeutung und 1-Jahres-Follow-up.