Document Detail

Assessment of acute myocardial necrosis after cardiopulmonary resuscitation and cardioversion by means of combined thallium-201/technetium-99m pyrophosphate tomography.
MedLine Citation:
PMID:  8575479     Owner:  NLM     Status:  MEDLINE    
Diagnosis of acute myocardial necrosis by means of conventional electrocardiographic criteria or the release of cardiac enzymes is often difficult or even impossible in patients with out-of-hospital cardiac arrest due to ventricular fibrillation with subsequent cardiopulmonary resuscitation including several DC countershocks. Simultaneous thallium-201/technetium-99m pyrophosphate (PYP) tomography was prospectively applied to 57 patients without typical clinical or electrocardiographic signs of acute myocardial infarction within 48 h after successful resuscitation from out-of-hospital cardiac arrest. Scintigraphic evidence of acute necrosis was present in 23/57 patients (40%). Increased 99mTc-PYP uptake in the pericardial tissue was found in 24 patients (42%). Maximal creatine kinase (CK) concentration was increased in 50/57 patients (88%). CK-MB activity averaged 68+/-52 U/l in patients with positive and 17+/-13 U/l in patients with negative tomograms (P<0.0005), demonstrating the validity of 201Tl/99mTc-PYP tomography. It may be concluded that simultaneous 201Tl/99mTc-PYP tomography is a valuable tool for evaluation of myocardial necrosis after cardiopulmonary resuscitation including DC countershock. Acute myocardial necrosis, as indicated by scintigraphy, represents a potential trigger for the occurrence of ventricular fibrillation. Therefore, 201Tl/99mTc-PYP tomography can be recommended in order to guide further diagnostic and therapeutic interventions in patients after cardiopulmonary resuscitation in whom the underlying cause of the occurrence of ventricular fibrillation is obscure.
T Krause; S H Hohnloser; W Kasper; C Schümichen; M Reinhardt; E Moser
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of nuclear medicine     Volume:  22     ISSN:  0340-6997     ISO Abbreviation:  Eur J Nucl Med     Publication Date:  1995 Nov 
Date Detail:
Created Date:  1996-03-13     Completed Date:  1996-03-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7606882     Medline TA:  Eur J Nucl Med     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  1286-91     Citation Subset:  IM    
Radiologische Universitätsklinik, Abteilung Nuklearmedizin, Freiburg, Germany.
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MeSH Terms
Acute Disease
Aged, 80 and over
Cardiopulmonary Resuscitation*
Creatine Kinase / blood
Electric Countershock*
Heart / radionuclide imaging*
Middle Aged
Myocardium / pathology*
Prospective Studies
Technetium Tc 99m Pyrophosphate / diagnostic use*
Thallium Radioisotopes / diagnostic use*
Ventricular Fibrillation / therapy
Reg. No./Substance:
0/Isoenzymes; 0/Technetium Tc 99m Pyrophosphate; 0/Thallium Radioisotopes; EC Kinase

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