[The detection of acute myocardial infarct without a Q wave; indium-111-labelled antimyosin antibodies versus technetium-99m-labelled radiophosphates].
In order to ascertain whether antimyosin myocardial imaging is superior to the more conventional cardiac radiophosphate scanning for the diagnosis of non Q wave acute myocardial infarction (AMI), we conducted a comparative study with the contemporary use of both tracers. Forty eight patients admitted to the coronary care unit of our centre because of non Q AMI, were included. Between two and seven days after onset, cardiac scintigraphy was performed both using 99mTc labelled diphosphonic-propane-dicarboxylic acid (99mTc-DPD) and 111indium labelled antimyosin (111In-AAM). In addition to planar imaging, tomoscintigraphy (SPECT) with 99mTc-DPD was obtained in 12 patients. 99mTc-DPD imaging was positive for AMI in 44% of the cases, while 111In-AAM in 52% (NS). In most positive cases (more than 85%) myocardial necrosis was localised in the posterolateral wall. In the subgroup of SPECT imaged patients, the percentage of positive findings was the same as the percentage using planar 111In-AAM imaging (58%). We conclude that the apparent efficacy of antimyosin for the diagnosis of non Q AMI is similar to that of 99mTc-DPD imaging. We feel that owing to its higher cost, such procedure should be saved for those cases were standard 99mTc-DPD imaging fails to detect the infarcted myocardium.
Cortadellas Angel
J
J
Servicio de Cardiología, Hospital General Universitario de la Vall D'Hebron, Barcelona.
Candell Riera
J
J
Castell Conesa
J
J
López Amor
M F
MF
González González
J M
JM
Soler Soler
J
J
Domènech Torné
F
F
D000368:Aged; D000704:Analysis of Variance; D000906:Antibodies / Q000009:adverse effects; D001219:Aspartate Aminotransferases / Q000097:blood; D016009:Chi-Square Distribution; D004796:Clinical Enzyme Tests; D003402:Creatine Kinase / Q000097:blood; D004164:Diphosphonates; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007205:Indium Radioisotopes; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology; D009218:Myosins / Q000276:immunology*; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity
D000906:Antibodies; D004164:Diphosphonates; D007205:Indium Radioisotopes; D007527:Isoenzymes; D015609:Organotechnetium Compounds; C033905:technetium Tc 99m 1,1-diphosphonopropane-2,3-dicarboxylic acid; D001219:Aspartate Aminotransferases; D003402:Creatine Kinase; D009218:Myosins
Detección del infarto agudo de miocardio sin onda Q; anticuerpos antimiosina marcados con indio-111 frente a radiofosfatos marcados con tecnecio-99m.