Document Detail

Assessment of "microvascular no-reflow phenomenon" using technetium-99m macroaggregated albumin scintigraphy in patients with acute myocardial infarction.
MedLine Citation:
PMID:  9768709     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The aim of this study was the scintigraphic evaluation of clinical no-reflow phenomenon. BACKGROUND: In patients with acute myocardial infarction, the relationship of the severity of reduction of microvascular reflow to the ischemia time or to the secondary extension of myocardial necrosis is poorly understood, and we accordingly conducted a scintigraphic evaluation of clinical no-reflow phenomenon. METHODS: The group studied consisted of 25 consecutive patients with their first acute myocardial infarction. After recanalization, each patient received intracoronary injections of technetium-99m macroaggregated albumin (MAA). RESULTS: Eight patients (32%) had absent tracer uptake (scintigraphic no-reflow phenomenon). Fourteen patients showed absent or moderately reduced MAA uptake (group 1) and 11 showed slightly reduced or normal uptake (group 2). The time to recanalization was significantly longer in group 1 than in group 2 (290.4+/-130.6 min vs. 1773+/-93.5 min; p=0.0238). In chronic phase, the thallium-201 (TI-201) defect score index was significantly larger (p < 0.01) and regional ejection fraction was significantly lower (p < 0.01) in group 1 compared with corresponding values in group 2. No significant deterioration from acute phase to chronic phase in either TI-201 defect score index or regional ejection fraction was found in either group (two-way repeated measures analysis of variance). CONCLUSIONS: These findings suggest that scintigraphic noreflow phenomenon occurs in a subgroup of patients without angiographic no-reflow phenomenon, that the myocardial damage depends on the severity of microvascular damage and that prolonged ischemia time may increase the likelihood of "microvascular no-reflow phenomenon."
M Kondo; A Nakano; D Saito; Y Shimono
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  32     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1998 Oct 
Date Detail:
Created Date:  1998-10-20     Completed Date:  1998-10-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  898-903     Citation Subset:  AIM; IM    
Division of Cardiology, Shimada Municipal Hospital, Shizuoka, Japan.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Angiography
Coronary Circulation*
Middle Aged
Myocardial Infarction / physiopathology*,  radiography,  radionuclide imaging,  therapy
Myocardial Reperfusion
Radiopharmaceuticals / diagnostic use*
Technetium Tc 99m Aggregated Albumin / diagnostic use*
Thallium Radioisotopes / diagnostic use
Tomography, Emission-Computed, Single-Photon
Reg. No./Substance:
0/Radiopharmaceuticals; 0/Technetium Tc 99m Aggregated Albumin; 0/Thallium Radioisotopes

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