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
(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.