Effect of infarct location on myocardial salvage assessed by technetium-99m isonitrile
TF Christian,
RJ Gibbons,
and
BJ Gersh
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota 55905.
To investigate the influence of infarct location on myocardial salvage, technetium-99m isonitrile was injected into 43 patients with a first myocardial infarction before early reperfusion therapy. Primary coronary angioplasty was performed in 22 patients and successful intravenous thrombolytic therapy was given to 15 patients, both within 6 h of the onset of chest pain. Patency of the infarct-related artery was confirmed by angiography in all 37 patients. In the remaining six patients (three with and three without early thrombolytic therapy) the infarct-related artery remained occluded. Single photon emission computed tomography was performed within 6 h of the administration of technetium-99m isonitrile and repeated at the time of hospital discharge. Radionuclide ejection fraction at discharge was significantly lower for patients with anterior infarction (0.41 +/- 0.12) than for those with inferior infarction (0.56 +/- 0.09, p less than 0.001). Early perfusion defect size, a measure of myocardium at risk, was greater in patients with anterior than in those with inferior infarction (52 +/- 9% vs. 18 +/- 10% of the left ventricle, p = 0.0001) as was final defect size (30 +/- 20% vs. 9 +/- 8%, p less than 0.01). The change in myocardial perfusion, an estimate of myocardial salvage, was also greater in patients with anterior infarction (24 +/- 16% vs. 10 +/- 7%, p less than 0.01). However, the proportion of jeopardized myocardium salvaged (salvage index) was not significantly different between patients with anterior or inferior infarction (0.49 +/- 0.34 vs. 0.59 +/- 0.35, p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
This article has been cited by other articles:
|
|
|
|
 
P Chareonthaitawee, R J Gibbons, R S Roberts, T F Christian, and R Burns
The impact of time to thrombolytic treatment on outcome in patients with acute myocardial infarction
Heart,
August 1, 2000;
84(2):
142 - 148.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. J. Gibbons, T. D. Miller, and T. F. Christian
Infarct Size Measured by Single Photon Emission Computed Tomographic Imaging With 99mTc-Sestamibi : A Measure of the Efficacy of Therapy in Acute Myocardial Infarction
Circulation,
January 4, 2000;
101(1):
101 - 108.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. F. Christian, P. B. Berger, M. K. O Connor, D. O. Hodge, and R. J. Gibbons
Threshold Values for Preserved Viability With a Noninvasive Measurement of Collateral Blood Flow During Acute Myocardial Infarction Treated by Direct Coronary Angioplasty
Circulation,
December 14, 1999;
100(24):
2392 - 2395.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Medrano, R. W. Lowry, J. B. Young, D. G. Weilbaecher, L. H. Michael, I. Afridi, Z.-X. He, J. J. Mahmarian, and M. S. Verani
Assessment of Myocardial Viability With 99mTc Sestamibi in Patients Undergoing Cardiac Transplantation: A Scintigraphic/Pathological Study
Circulation,
September 1, 1996;
94(5):
1010 - 1017.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
G. L. Schaer, L. J. Spaccavento, K. F. Browne, K. A. Krueger, D. Krichbaum, J. M. Phelan, W. O. Fletcher, C. L. Grines, S. Edwards, M. K. Jolly, et al.
Beneficial Effects of RheothRx Injection in Patients Receiving Thrombolytic Therapy for Acute Myocardial Infarction: Results of a Randomized, Double-Blind, Placebo-Controlled Trial
Circulation,
August 1, 1996;
94(3):
298 - 307.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
T. D. Miller, T. F. Christian, M. R. Hopfenspirger, D. O. Hodge, B. J. Gersh, and R. J. Gibbons
Infarct Size After Acute Myocardial Infarction Measured by Quantitative Tomographic 99mTc Sestamibi Imaging Predicts Subsequent Mortality
Circulation,
August 1, 1995;
92(3):
334 - 341.
[Abstract]
[Full Text]
|
|
|
|
