title: Rest-redistribution thallium-201 scintigraphy to determine myocardial viability early after myocardial infarction.
abstract: OBJECTIVE
  This study attempted to determine the utility of early rest-redistribution thallium-201 imaging in detecting residual myocardial viability after myocardial infarction.
  
  
  BACKGROUND
  The early detection of myocardial viability after myocardial infarction would have clinical relevance.
  
  
  METHODS
  Thirty-one patients with acute myocardial infarction had early (mean [+/- SD] 2 +/- 1 day) rest-redistribution thallium-201 imaging followed by radionuclide and coronary angiography. Late studies included stress-redistribution-reinjection thallium-201 imaging or radionuclide angiography, or both. Viability was defined by the rest thallium-201 scan as an initial mild rest defect or any defect that demonstrated redistribution.
  
  
  RESULTS
  Group 1 (n = 15) was predicted to have viable and Group 2 (n = 16) nonviable myocardium in the infarct zone. Group 1 patients were more likely to have a patent infarct-related artery (15 of 15 vs. 10 of 16, p < 0.03), higher initial ejection fraction (61 +/- 12% vs. 53 +/- 9%, p < 0.05), higher infarct wall motion score (p < 0.0001) and fewer abnormal thallium-201 segments (p < 0.0001). On follow-up studies, ejection fraction improved in Group 1 (from 57 +/- 13% to 66 +/- 10%, p < 0.05, n = 9) and deteriorated in Group 2 (from 53 +/- 10% to 46 +/- 8%, p < 0.05, n = 13). On late stress testing with thallium-201 reinjection, Group 1 patients had fewer abnormal segments (p < 0.03) and higher infarct zone counts during exercise (p < 0.05) and after reinjection (p < 0.05) than Group 2 patients.
  
  
  CONCLUSIONS
  If confirmed by larger studies, early rest-redistribution thallium-201 imaging may be a useful technique for identifying residual viability after myocardial infarction.
authors.affiliation: Department of Internal Medicine, Medical College of Pennsylvania, Allegheny General Hospital, Pittsburg 15212.
authors.forename: C T
authors.initials: CT
authors.lastname: Lomboy
authors.forename: D S
authors.initials: DS
authors.lastname: Schulman
authors.forename: H P
authors.initials: HP
authors.lastname: Grill
authors.forename: A R
authors.initials: AR
authors.lastname: Flores
authors.forename: J E
authors.initials: JE
authors.lastname: Orie
authors.forename: J E
authors.initials: JE
authors.lastname: Granato
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D017023:Coronary Angiography; D005080:Exercise Test / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000628:therapy; D011446:Prospective Studies; D011875:Radionuclide Angiography / Q000706:statistics & numerical data; D012146:Rest; D018709:Statistics, Nonparametric; D013794:Thallium Radioisotopes; D013997:Time Factors
chemical_list: D013794:Thallium Radioisotopes