Korean J Nucl Med.  2003 Aug;37(4):219-228.

Prediction of Salvaged Myocardium in Patients with Acute Myocardial Infarction after Primary Percutaneous Coronary Angioplasty using early Thallium-201 Redistribution Myocardial Perfusion Imaging

• Choi JY
• Yang YJ
• Choi SJ
• Yeo JS
• Park SW
• Song JK
• Moon DH

Abstract

PURPOSE
The amount of salvaged myocardium is an important prognostic factor in patients with acute myocardial infarction (MI). We investigated if early Tl-201 SPECT imaging could be used to predict the salvaged myocardium and functional recovery in acute MI after primary PTCA. MATERIALS AND METHODS: In 36 patients with first acute MI treated with primary PTCA, serial echocardiography and Tl-201 SPECT imaging (5.8+/-2.1 days after PTCA) were performed. Regional wall motion and perfusion were quantified with on 16-segment myocardial model with 5-point and 4-point scaling system, respectively. RESULTS: Wall motion was improved in 78 of the 212 dyssynergic segments on 1 month follow-up echocardiography and 97 on 7 months follow-up echocardiography, which were proved to be salvaged myocardium. The areas under receiver operating characteristic curves of Tl-201 perfusion score for detecting salvaged myocardial segments were 0.79 for 1 month follow-up and 0.83 for 7 months follow-up. The sensitivity and specificity of Tl-201 redistribution images with optimum cutoff of 40% of peak thallium activity for detecting salvaged myocardium were 84.6% and 55.2% for 1 month follow-up, and 87.6% and 64.3% for 7 months follow-up, respectively. There was a linear relationship between the percentage of peak thallium activity on early redistribution imaging and the likelihood of segmental functional improvement 7 months after reperfusion. CONCLUSION: Tl-201 myocardial perfusion SPECT imaging performed early within 10 days after reperfusion can be used to predict the salvaged myocardium and functional recovery with high sensitivity during the 7 months following primary PTCA in patients with acute MI.

Keyword

Thallium-201; myocardial perfusion SPECT; acute myocardial infarction; primary percutaneous transluminal coronary angioplasty

MeSH Terms

Angioplasty*
Echocardiography
Follow-Up Studies
Humans
Myocardial Infarction*
Myocardial Perfusion Imaging*
Myocardium*
Perfusion
Reperfusion
ROC Curve
Sensitivity and Specificity
Thallium
Tomography, Emission-Computed, Single-Photon
Thallium