IMPORTANCE OF FLOW METABOLISM STUDIES IN PREDICTING LATE RECOVERY OF FUNCTION FOLLOWING REPERFUSION IN PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION/

Aims Positron emission tomographic imaging is known to be a reliable i ndicator of viable myocardium in chronic heart disease. Its value in a cute myocardial infarction has not been studied extensively. Methods a nd results Sixty-two patients receiving thrombolytic therapy were stud ied. Myocardial tissue flow and metabolism were measured at 5 days and 3 months. Recovery of left ventricular function was investigated with echocardiography or radionuclide ventriculography. In eight patients, normal flow was found in the infarct area at 5 days with no significa nt changes in flow, metabolism or function over the next 3 months. In 54 patients. impaired regional myocardial blood flow in the infarct zo ne was observed at 5 days. In 39 patients, there was a matching positr on emission tomographic pattern, while in 15 the pattern was mismatche d. None of the patients with a TIMI flow grade <3 revealed recovery of left ventricular function. In seven out of 11 patients with TIMI 3 fl ow and a mismatching pattern, additional angioplasty was performed wit h functional improvement in six. Conclusions Recovery of ventricular f unction is exclusively found in patients with a TIMI flow grade 3. Pat ients with a positron emission tomographic mismatching pattern reveal functional recovery only after subsequent angioplasty.