Document Detail


Comparison of the predischarge exercise thallium-201 perfusion defect after myocardial infarction with myocardium at risk measured during acute infarction with technetium-99m sestamibi imaging.
MedLine Citation:
PMID:  12595856     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Exercise thallium-201 imaging provides a noninvasive estimate of the amount of myocardium presumed to be at risk of infarcting should a complete occlusion of the coronary stenosis occur. The relationship between the size of the exercise thallium perfusion defect and the extent of myocardium supplied by a diseased coronary artery has not been established. This study evaluates that presumed correlation. METHODS: Patients were injected intravenously with technetium-99m sestamibi during acute myocardial infarction before thrombolysis or conventional therapy to quantify the myocardium at risk. Twenty-six patients who underwent risk-area assessment subsequently underwent clinically driven, predischarge, submaximal exercise imaging with thallium-201. The exercise testing was performed on day 7 +/- 2 days. A conventional polar map display was used to quantify the perfusion defect. RESULTS: The myocardium at risk determined by technetium-99m sestamibi at the time of infarction was 30% +/- 20% of the left ventricle. The mean exercise thallium-201 defect was 34% +/- 22% of the left ventricle. The exercise defect tended to be slightly larger than the myocardium at risk (4% +/- 10% of the left ventricle, P =.05). There was a close correlation between the 2 measurements (r = 0.89, SE = 9.4, P <.0001). CONCLUSIONS: This study shows a close correlation between the myocardium "at risk" assessed acutely by technetium-99m sestamibi and the "presumed at-risk area" determined by thallium-201 imaging on predischarge exercise testing. This finding supports the concept that the size of the exercise thallium defect caused by coronary stenosis indicates the likely size of a myocardial infarction resulting from occlusion of that stenosis.
Authors:
André C Lapeyre; Mark A Evans; Timothy F Christian; John R Daley; Raymond J Gibbons
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  145     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-21     Completed Date:  2003-03-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  357-63     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Foundation, Rochester, MN 55905, USA. alapeyre@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Exercise Test
Female
Humans
Male
Middle Aged
Myocardial Infarction / drug therapy,  physiopathology,  radionuclide imaging*
Myocardial Reperfusion
Prospective Studies
Radiopharmaceuticals / diagnostic use*
Regression Analysis
Risk
Technetium Tc 99m Sestamibi / diagnostic use*
Thallium Radioisotopes / diagnostic use*
Thrombolytic Therapy
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 0/Thallium Radioisotopes; 109581-73-9/Technetium Tc 99m Sestamibi

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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