QUANTIFICATION OF MYOCARDIAL-INFARCTION DURING CORONARY-OCCLUSION AND MYOCARDIAL SALVAGE AFTER REPERFUSION USING CARDIAC IMAGING WITH TECHNETIUM-99M HEXAKIS 2-METHOXYISOBUTYL ISONITRILE

[摘要] Myocardial imaging with technetium-99m hexakis 2-methoxyisobutyl isonitrile was investigated as a means to assess myocardial infarct size during coronary occlusion and quantify the extent of salvaged myocardium after coronary occlusion followed by reperfusion. Open chest dogs underwent either a permanent coronary artery occlusion (Group 1, n = 16) or a 2 h occlusion followed by reperfusion (Group 2, n = 15). Animals in both groups were killed 48 h after occlusion. During coronary occlusion, 23 of the 25 dogs that survived the coronary occlusions had abnormal myocardial scintigrams. The scintigraphic perfusion defect size correlated well with the pathologic infarct size (r = 0.85 and 0.95 by planar and tomographic imaging, respectively). The planar scintigraphic defect size, but not the tomographic defect size, overestimated the pathologic size. The planar scintigraphic defect size observed during coronary occlusion was markedly reduced 48 h after perfusion (24.8 .+-. 12.8% to 10.6 .+-. 9.7% of the left ventricle, p < 0.003). The uptake of technetium-99m hexakis 2-methoxyisobutylisonitrile in the ischemic myocardium increased significantly 48 h after reperfusion (p < 0.003) and correlated with the increased in regional myocardial blood flow, as assessed by radioactive microspheres (r = 0.83, p < 0.01). Thus, myocardial imaging with technetium-99m hexakis 2-methoxyisobutyl isonotrile reliable demonstration of the presence of acute infarction, estimation of infarct size and quantification of the extent of salvaged myocardium, after coronary reperfusion.

[发布日期] 1988-12-01