Relationship between resting Tl-201 reverse redistribution, microvascular perfusion, and functional recovery in acute myocardial infarction

Citation
M. Faraggi et al., Relationship between resting Tl-201 reverse redistribution, microvascular perfusion, and functional recovery in acute myocardial infarction, J NUCL MED, 41(3), 2000, pp. 393-399
Citations number
36
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
Journal title
JOURNAL OF NUCLEAR MEDICINE
ISSN journal
01615505 → ACNP
Volume
41
Issue
3
Year of publication
2000
Pages
393 - 399
Database
ISI
SICI code
0161-5505(200003)41:3<393:RBRTRR>2.0.ZU;2-J
Abstract
(TI)-T-201 reverse redistribution is a common finding early after reperfusi on therapy for myocardial infarction. Its mechanism and clinical implicatio ns remain unclear. The aim of this study was to clarify the relationships b etween reverse redistribution, microvascular perfusion, and myocardial viab ility. Methods: Resting, 10-min-postinjection, and redistribution (TI)-T-20 1 data obtained for 33 patients 8 and 42 d after the onset of acute myocard ial infarction were compared with echocardiographic wall motion measured ac utely and on day 42. Microvascular perfusion was assessed by myocardial con trast echocardiography performed 10 min after restoration of complete paten cy of the infarct artery. Results: Marked significant reverse redistributio n was found on day 8 (absolute change, 7.5% +/- 7.9% of the 10-min-postinje ction defect size; P < 5 x 0.000001) and significantly decreased on day 42 (2.7% +/- 6.8%; P = 0.004 between days 8 and 42). The 10-min-postinjection defect size best predicted the final infarct size on day 42 and was closely related to microvascular perfusion. Patients with adequate reperfusion had a smaller postinjection defect on day 8 (21.1% +/- 14.6%) and a larger rev erse redistribution (10.2% +/- 6.1%) than did patients with no reflow (35.3 % +/- 13% and 3.2% +/- 9.2%, respectively; P < 0.04 for both). Conclusion: Reverse redistribution was marked early after myocardial infarction in pati ents with complete patency of the infarct artery and decreased in subsequen t weeks. Reverse redistribution was associated with restoration of adequate microvascular reperfusion and with myocardial salvage and viability. The e arly postinjection scans on day 8 were the relevant images for assessing my ocardial salvage and predicting wall motion recovery.