Document Detail


Use of thallium-201 redistribution scintigraphy in the preoperative differentiation of reversible and nonreversible myocardial asynergy.
MedLine Citation:
PMID:  6974614     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Thallium-201 (201Tl) redistribution scintigraphy might differentiate reversibly from nonreversibly asynergic myocardial segments and thus predict the response of these segments to coronary artery bypass grafting (CABG). To test this hypothesis, 25 consecutive patients undergoing CABG, preoperative stress-redistribution 201Tl scintigraphy, and both pre- and postoperative resting equilibrium radionuclide ventriculography were evaluated. For both types of scintigraphic study, each patient was imaged in the same three views. Because of the effects of CABG on septal motion, this region was considered separately. Postoperative improvement was noted in 54% of 72 preoperative asynergic segments. Improvement was common not only in hypokinetic but also in akinetic and dyskinetic segments, and occurred in a similar proportion of studies performed early (less than 2 weeks) or late (3-6 months) after CABG. Thallium-201 redistribution scintigraphy was highly predictive of the pattern of postoperative asynergy: The redistribution pattern was normal in 90% of segments with reversible asynergy and abnormal in 76% of segments with nonreversible asynergy. The presence or absence of pathologic Q waves was less sensitive in this differentiation. Septal segments, however, frequently demonstrated abnormal wall motion postoperatively, despite normal 201Tl redistribution scintigraphy. Resting left ventricular ejection fraction (LVEF) was generally unchanged postoperatively, but in some patients with multiple areas of reversible asynergy it did improve. Thus, 201Tl redistribution scintigraphy appears to reliably distinguish viable from nonviable asynergic myocardial zones, and predicts the response of these segments to CABG.
Authors:
A Rozanski; D S Berman; R Gray; R Levy; M Raymond; J Maddahi; N Pantaleo; A D Waxman; H J Swan; J Matloff
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  64     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1981 Nov 
Date Detail:
Created Date:  1981-12-15     Completed Date:  1981-12-15     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  936-44     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Coronary Artery Bypass
Electrocardiography
Female
Heart Septal Defects / diagnosis
Heart Ventricles / radionuclide imaging
Humans
Kinetics
Male
Middle Aged
Myocardial Contraction
Myocardial Infarction / diagnosis,  surgery
Postoperative Care
Preoperative Care
Radioisotopes / diagnostic use*
Thallium / diagnostic use*
Grant Support
ID/Acronym/Agency:
SCOR 17651/SC/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Radioisotopes; 7440-28-0/Thallium

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


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