[Simultaneous double nucleotide scintigraphy with indium 111 antimyosin Fab and technetium sestamibi for evaluation of myocardial viability after experimental and clinical infarct].
This study combined In-111 antimyosin Fab (AM) with Tc-99m sestamibi (MIBI) to assess myocardial viability in the subacute stage of infarction. In 9 pigs, the LAD was occluded for 45 min. Seventy-four MBq of AM were injected after 48 h of reperfusion and 740 MBq of MIBI 24 h later. In myocardial specimens, activity relative to normal myocardium (n = 35) in the region of necrosis (n = 35) was found to be 3.96 +/- 2.48 for AM and 0.30 +/- 0.20 for MIBI, in the intermediate zone of macrohistochemically reversibly damaged myocardium (n = 35) 2.79 +/- 1.29 and 0.83 +/- 0.28, respectively. Discriminant analysis classified all 105 specimens with a sensitivity of 83% and specificity of 96%. On the scans, the intermediate zone presented as overlap between both tracers. Twelve patients aged 40 to 76 years with invasively documented acute myocardial infarction (4 x anterior, 8 x inferior) were injected also with 74 MBq of AM 27 to 110 h after the onset of chest pain and with 740 MBq of MIBI 21 to 26 h later. In 8 patients, the infarct vessel was open not later than 5 h after the onset of chest pain. MIBI markedly supported reconstruction of the sections and localization of the lesions with AM on simultaneous double-nuclide single-photon emission computed tomography (SPECT). In 7 patients both tracers overlapped. Four patients showed only faint AM uptake. This demonstrates that in experimental infarction AM overestimates the region of necrosis while the combination with MIBI allows the delineation towards the intermediate zone and normal myocardium. In patients, SPECT shows similar patterns of tracer distribution. MIBI facilitates AM SPECT.
Morguet
A J
AJ
Abteilung für Kardiologie und Pulmonologie Zentrum Innere Medizin Georg-August-Universität, Göttingen.
Munz
D L
DL
Kreuzer
H
H
Emrich
D
D
D000328:Adult; D000368:Aged; D000818:Animals; D000911:Antibodies, Monoclonal; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000473:pathology; D015428:Myocardial Reperfusion Injury / Q000000981:diagnostic imaging* / Q000473:pathology; D009336:Necrosis; D009942:Organometallic Compounds; D016719:Radioimmunodetection; D013552:Swine; D013556:Swine, Miniature; D017256:Technetium Tc 99m Sestamibi; D014022:Tissue Survival / Q000502:physiology*; D015899:Tomography, Emission-Computed, Single-Photon
D000911:Antibodies, Monoclonal; D009942:Organometallic Compounds; C058899:imciromab pentetate; D017256:Technetium Tc 99m Sestamibi
Simultane Doppelnuklid-Szintigraphie mit Indium-111-Antimyosin-Fab und Technetium-99m-Sestamibi zur Beurteilung der Myokardvitalität nach experimentellem und klinischem Infarkt.