Clinical significance of reverse redistribution phenomenon after coronary artery bypass grafting.
The reverse redistribution (RR) phenomenon is a decrease in thallium 201 uptake during redistribution compared with 201Tl uptake immediately after exercise. We evaluated RR in 23 patients after coronary artery bypass grafting. Postoperative RR was present in 48% and was significantly more common in patients with a history of myocardial infarction (62%). The patients were classified according to the presence (+) or absence (-) of RR. An analysis of left ventricular wall motion showed significant improvement after coronary artery bypass grafting in the RR+ group (n = 12) but not in the RR- group (n = 11). Quantitative myocardial viability was evaluated using the defect volume ratio, mean defect severity, and defect severity index. The preoperative defect volume ratio was higher in the RR+ group than in the RR- group (p < 0.05). In the RR- group, no improvement in these indices was observed after operation. In contrast, the RR+ group showed significant improvement in all three indices (p < 0.05). These results indicate that after coronary artery bypass grafting, an adequate blood supply to the remaining myocardium may induce RR. This phenomenon, therefore, may be a significant indicator of postoperative myocardial viability.
Watarida
S
S
Second Department of Surgery, Shiga University of Medical Science, Japan.
Onoe
M
M
Sugita
T
T
Tabata
R
R
Katsuyama
K
K
Nakajima
Y
Y
Nojima
T
T
Yamamoto
R
R
Matsuno
S
S
Mori
A
A
D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012720:Severity of Illness Index; D013794:Thallium Radioisotopes / Q000493:pharmacokinetics*; D014018:Tissue Distribution; D015899:Tomography, Emission-Computed, Single-Photon; D016277:Ventricular Function, Left
D013794:Thallium Radioisotopes