Regional distribution of 123I-(ortho-iodophenyl)-pentadecanoic acid and 99Tcm-MIBI in relation to wall motion after thrombolysis for acute myocardial infarction.
To characterize the myocardium after thrombolytic therapy for infarction single photon emission computed tomographic (SPECT) studies with 123I-(ortho-iodophenyl)-pentadecanoic acid (oPPA) and 99Tcm-methoxyisobutyl isonitrile (MIBI) were obtained at rest in nine patients within a fortnight after the acute event. A decreased oPPA activity compared to MIBI was observed in 15/45 segments (7/9 patients). The segments with discordant oPPA/MIBI activities showed less severe wall motion abnormalities than the segments with concordant decreased oPPA and MIBI activities (P = 0.004). A significant association was found between discordant oPPA/MIBI activities and the early evolution of wall motion following thrombolysis: discordant oPPA/MIBI activities were present in nine of the 11 segments (82%) with improved wall motion, while the wall motion of the seven segments with similar decreased oPPA and MIBI activities was unchanged or had deteriorated (P = 0.018). It is concluded that metabolic abnormalities often persist longer than perfusion and wall motion abnormalities soon after thrombolysis, and that 123I-oPPA in combination with 99Tcm-MIBI is useful to demonstrate myocardial areas which have been salvaged by thrombolysis.
Franken
P R
PR
Department of Nuclear Medicine, University Hospital, Free University of Brussels (VUB), Belgium.
De Geeter
F
F
Dendale
P
P
Block
P
P
Bossuyt
A
A
D000368:Aged; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes / Q000493:pharmacokinetics*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D009570:Nitriles / Q000493:pharmacokinetics*; D015609:Organotechnetium Compounds / Q000493:pharmacokinetics*; D013300:Streptokinase / Q000627:therapeutic use*; D017256:Technetium Tc 99m Sestamibi; D015912:Thrombolytic Therapy; D015899:Tomography, Emission-Computed, Single-Photon
D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D009570:Nitriles; D015609:Organotechnetium Compounds; C025391:omega-(4-iodophenyl)pentadecanoic acid; D006493:Heparin; D017256:Technetium Tc 99m Sestamibi; D013300:Streptokinase