EFFECTS OF MYOCARDIAL REVASCULARIZATION ON REGIONAL TL-201 UPTAKE ANDSYSTOLIC FUNCTION IN REGIONS WITH REVERSE REDISTRIBUTION ON TOMOGRAPHIC TL-201 IMAGING AT REST IN PATIENTS WITH CHRONIC CORONARY-ARTERY DISEASE

Objectives. There is growing evidence that myocardial segments with re verse redistribution are viable in patients with chronic coronary arte ry disease. The aim of this study was to assess the effects of myocard ial revascularization on systolic function and thallium-201 uptake in such segments. Methods. Rest-redistribution thallium-201 tomography be fore and after myocardial revascularization was performed in 47 patien ts with chronic coronary artery disease. Regional function was evaluat ed by two-dimensional echocardiography before and after revascularizat ion according to a 3-point scale (1 = normal, 2 = hypokinetic, 3 = a/d yskinetic). Improvement of dysfunctional segments was defined when sys tolic function score decreased greater than or equal to 1 after revasc ularization, Reverse redistribution was defined as greater than or equ al to 8% decrease in relative thallium-201 uptake between rest and red istribution images, Results. Reverse redistribution was found in 27 (5 7%) of 47 patients, corresponding to 60 (11%) of 564 myocardial segmen ts. Of such segments, 24 (40 %) had normal systolic function, 19 (32%) were hypokinetic, and 17 (28%) were a/dyskinetic, Thirty-six segments underwent myocardial revascularization, and reverse redistribution wa s no longer present in 86% of them subsequent to the procedure. Of 26 dyssynergic segments with reverse redistribution subjected to revascul arization, 18 (69%) improved at follow-up, Conclusions. The findings o f the present study indicate that reverse redistribution is a reversib le phenomenon and is often associated with improvement of systolic fun ction following revascularization in patients with chronic coronary ar tery disease.