Importance of flow/metabolism studies in predicting late recovery of function following reperfusion in patients with acute myocardial infarction.
OBJECTIVE
Positron emission tomographic imaging is known to be a reliable indicator of viable myocardium in chronic heart disease. Its value in acute myocardial infarction has not been studied extensively.


RESULTS
Sixty-two patients receiving thrombolytic therapy were studied. Myocardial tissue flow and metabolism were measured at 5 days and 3 months. Recovery of left ventricular function was investigated with echocardiography or radionuclide ventriculography. In eight patients, normal flow was found in the infarct area at 5 days with no significant changes in flow, metabolism or function over the next 3 months. In 54 patients, impaired regional myocardial blood flow in the infarct zone was observed at 5 days. In 39 patients, there was a matching positron emission tomographic pattern, while in 15 the pattern was mismatched. None of the patients with a TIMI flow grade < 3 revealed recovery of left ventricular function. In seven out of 11 patients with TIMI 3 flow and a mismatching pattern, additional angioplasty was performed with functional improvement in six.


CONCLUSIONS
Recovery of ventricular function is exclusively found in patients with a TIMI flow grade 3. Patients with a positron emission tomographic mismatching pattern reveal functional recovery only after subsequent angioplasty.
Maes
A
A
Department of Nuclear Medicine, UZ Gasthuisberg, Leuven, Belgium.
Mortelmans
L
L
Nuyts
J
J
Bormans
G
G
Herregods
M C
MC
Bijnens
B
B
Van de Werf
F
F
D000368:Aged; D000704:Analysis of Variance; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000502:physiology*; D004452:Echocardiography; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000188:drug therapy; D015425:Myocardial Reperfusion; D009206:Myocardium / Q000378:metabolism*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015635:Radionuclide Ventriculography; D012039:Regional Blood Flow / Q000502:physiology; D012680:Sensitivity and Specificity; D015912:Thrombolytic Therapy; D014055:Tomography, Emission-Computed; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology
D005947:Glucose