This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by De Coster, P. M. Articles by Melin, J. A. Search for Related Content PubMed PubMed Citation Articles by De Coster, P. M. Articles by Melin, J. A.

Circulation, Vol 82, 2152-2162, Copyright © 1990 by American Heart Association

ARTICLES

Area-at-risk determination by technetium-99m-hexakis-2-methoxyisobutyl isonitrile in experimental reperfused myocardial infarction

PM De Coster, W Wijns, F Cauwe, A Robert, C Beckers and JA Melin
Division of Cardiology, University of Louvain Medical School, Brussels, Belgium.

In a canine model of reperfused myocardial infarction, we tested the hypothesis that after reperfusion, technetium-99m-hexakis-2- methoxyisobutyl isonitrile (Tc-MIBI) tomographic imaging still reflects occlusion blood flow when the tracer is injected before reperfusion. Nine anesthetized dogs underwent 2 hours of coronary occlusion followed by 3 hours of reperfusion ending by being killed. Reference coronary blood flow was determined by radioactive microspheres injected during occlusion and after reperfusion. Biopsies in normal and ischemic myocardium and single photon emission computed tomography were obtained during occlusion and after reperfusion. Circumferential profiles were applied to axial slices divided into 5-degree sectors. The sectors were divided into 3 groups selected on the occlusion acquisition (normal, mildly reduced, and severely reduced) and compared with the postreperfusion acquisition. Tissular Tc-MIBI kinetics was assessed both by Tc-MIBI time-activity curves of normal and ischemic tissue obtained by biopsy and by the relative gradient between normal, ischemic, and necrotic postmortem tissue samples. In biopsy samples, Tc- MIBI content remained unchanged during occlusion and after reperfusion in normal as well as in ischemic tissue (4,662 +/- 2,237 counts/min/mg vs. 4,599 +/- 1,577 counts/min/mg in normal tissue, NS; 941 +/- 903 counts/min/mg vs. 1,087 +/- 721 counts/min/mg in ischemic tissue, NS). In postmortem tissue samples, there was a good correlation between occlusion microsphere blood flow and Tc-MIBI activity (r = 0.91). In the necrotic samples, mean normalized Tc-MIBI activity (10 +/- 17%) was slightly higher than the normalized microsphere blood flow (3 +/- 3%, p less than 0.001) but markedly lower than the normalized microsphere reperfusion blood flow (63 +/- 31%, p less than 0.001). Comparing the single photon emission computed tomographic acquisitions before and after reperfusion, Tc-MIBI activity remained unchanged in normal as well as in mildly reduced or severely reduced segments. Thus, our data are consistent with the hypothesis that Tc-MIBI traces blood flow, does not redistribute significantly despite reperfusion, and can be used for imaging the area at risk.

This article has been cited by other articles:

				J. T. Ortiz-Perez, J. Rodriguez, S. N. Meyers, D. C. Lee, C. Davidson, and E. Wu Correspondence Between the 17-Segment Model and Coronary Arterial Anatomy Using Contrast-Enhanced Cardiac Magnetic Resonance Imaging J. Am. Coll. Cardiol. Img., May 1, 2008; 1(3): 282 - 293. [Abstract] [Full Text] [PDF]

				B. De Bruyne and G. R. Heyndrickx Changes in Infarct Size and Left Ventricular Ejection Fraction: New Prognostic Factors After Acute Myocardial Infarction? J. Am. Coll. Cardiol., July 10, 2007; 50(2): 157 - 158. [Full Text] [PDF]

				O. Pereztol-Valdes, J. Candell-Riera, C. Santana-Boado, J. Angel, S. Aguade-Bruix, J. Castell-Conesa, E. V. Garcia, and J. Soler-Soler Correspondence between left ventricular 17 myocardial segments and coronary arteries Eur. Heart J., December 2, 2005; 26(24): 2637 - 2643. [Abstract] [Full Text] [PDF]

				G. Ndrepepa, J. Mehilli, M. Schwaiger, H. Schuhlen, S. Nekolla, S. Martinoff, C. Schmitt, J. Dirschinger, A. Schomig, and A. Kastrati Prognostic Value of Myocardial Salvage Achieved by Reperfusion Therapy in Patients with Acute Myocardial Infarction J. Nucl. Med., May 1, 2004; 45(5): 725 - 729. [Abstract] [Full Text] [PDF]

				I Jucquois, P Nihoyannopoulos, A-M D'Hondt, V Roelants, A Robert, J A Melin, D Glass, and J-L J Vanoverschelde Comparison of myocardial contrast echocardiography with NC100100 and 99mTc sestamibi SPECT for detection of resting myocardial perfusion abnormalities in patients with previous myocardial infarction Heart, May 1, 2000; 83(5): 518 - 524. [Abstract] [Full Text]

				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]

				W. Wijns, S. F. Vatner, and P. G. Camici Hibernating Myocardium N. Engl. J. Med., July 16, 1998; 339(3): 173 - 181. [Full Text] [PDF]

				E. D. Peterson, L. J. Shaw, and R. M. Califf Clinical Guideline: Part II: Risk Stratification after Myocardial Infarction Ann Intern Med, April 1, 1997; 126(7): 561 - 582. [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]

				R. J. Gibbons, D. R. Holmes, G. S. Reeder, K. R. Bailey, M. R. Hopfenspirger, B. J. Gersh, and The Mayo Coronary Care Unit and Catheterization La Immediate Angioplasty Compared with the Administration of a Thrombolytic Agent Followed by Conservative Treatment for Myocardial Infarction N. Engl. J. Med., March 11, 1993; 328(10): 685 - 691. [Abstract] [Full Text]