Prediction of left ventricular dilatation with thallium-201 SPET imaging after primary angioplasty in patients with acute myocardial infarction.
Progressive ventricular dilatation is an important prognostic factor in patients with acute myocardial infarction. We evaluated clinical, angiographic, echocardiographic and thallium-201 single-photon emission tomography (SPET) imaging variables predictive of the change in left ventricular volume during a 7-month follow-up period after primary angioplasty in patients with acute myocardial infarction. Thirty-six patients with first acute myocardial infarction treated with primary angioplasty within 12 h of onset underwent 201Tl SPET imaging (5.8+/-2.1 days after angioplasty). Changes in left ventricular volume were assessed over the 7-month period. The left ventricle dilated significantly after angioplasty ( P<0.001). Multivariate analysis revealed that the number of segments with 201Tl uptake <40% of peak activity was a single independent predictor of increase in end-diastolic volume index between 1 week and 7 months ( R2=0.41, P< 0.001). The presence of two or more segments with 201Tl uptake <40% predicted an increase in end-diastolic volume index of > or =6 ml/m2 with positive and negative predictive values of 85% (17/20) and 75% (12/16), respectively. It is concluded that, following primary angioplasty in patients with acute myocardial infarction, the extent of myocardial infarction assessed by 201Tl SPET can identify those who will develop ventricular dilatation during the subsequent 7 months.
Choi
Joon Young
JY
Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-dong, Songpa-gu, Seoul 138-736, Korea.
Moon
Dae Hyuk
DH
Lee
Cheol Whan
CW
Shin
Jung Woo
JW
Park
Seong-Wook
SW
Hong
Myeong-Ki
MK
Song
Jae-Kwan
JK
Park
Seung-Jung
SJ
Lee
Hee Kyung
HK
D000208:Acute Disease; D017130:Angioplasty; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D015588:Observer Variation; D011184:Postoperative Period; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D016037:Single-Blind Method; D013318:Stroke Volume; D013793:Thallium; D015899:Tomography, Emission-Computed, Single-Photon; D020257:Ventricular Remodeling
C027549:thallium chloride; D013793:Thallium