Document Detail


Myocardial thallium-201 scintigraphy for assessment of viability in patients with severe left ventricular dysfunction.
MedLine Citation:
PMID:  1442567     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Many patients with ischemic heart disease and depressed left ventricular (LV) function have asynergic zones with sustained microcirculatory perfusion and myocardial metabolic activity that exhibit improved systolic function after coronary revascularization. The 2 predominant noninvasive techniques used to determine myocardial viability in patients with severely depressed LV function are thallium-201 (201Tl) scintigraphy and positron emission tomography (PET). Myocardial extraction of 201Tl is unaltered under experimental conditions of myocardial stunning or short-term hibernation (characterized by decreased flow and ischemic dysfunction). Akinetic or dyskinetic LV wall segments can exhibit normal or near normal 201Tl uptake as long as some residual flow is present. 201Tl scintigraphy can identify viable asynergic segments when performed on patients with severe coronary artery disease who are in the resting state. Many of these patients have initial resting defects that demonstrate delayed redistribution, or mild persistent defects that show improved perfusion and function after revascularization. There is a direct correlation between the extent of 201Tl uptake in zones of severe regional myocardial asynergy and the magnitude of improvement in resting LV ejection fraction after coronary bypass surgery. Rest 201Tl scintigraphy may help in the selection of patients with coronary artery disease and severely depressed LV function who would benefit the most from revascularization.
Authors:
G A Beller; M Ragosta; D D Watson; L W Gimple
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  The American journal of cardiology     Volume:  70     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1992 Nov 
Date Detail:
Created Date:  1992-12-10     Completed Date:  1992-12-10     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  18E-22E     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, University of Virginia Health Sciences Center, Charlottesville 22908.
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MeSH Terms
Descriptor/Qualifier:
Animals
Cell Survival
Coronary Vessels / radionuclide imaging
Deoxyglucose / analogs & derivatives,  metabolism
Fluorodeoxyglucose F18
Heart / radionuclide imaging
Humans
Myocardial Ischemia / radionuclide imaging*
Myocardium / metabolism
Thallium Radioisotopes / diagnostic use*
Tomography, Emission-Computed*
Ventricular Function, Left*
Grant Support
ID/Acronym/Agency:
R01 HL26205-12/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Thallium Radioisotopes; 154-17-6/Deoxyglucose; 63503-12-8/Fluorodeoxyglucose F18

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


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