Prediction of Salvaged Myocardium in Patients with Acute Myocardial Infarction after Primary Percutaneous Coronary Angioplasty using early Thallium-201 Redistribution Myocardial Perfusion Imaging.
- Author:
Joon Young CHOI
1
;
You Jung YANG
;
Seung Jin CHOI
;
Jeong Seok YEO
;
Seong Wook PARK
;
Jae Kwan SONG
;
Dae Hyuk MOON
Author Information
1. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. dhmoon@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Thallium-201;
myocardial perfusion SPECT;
acute myocardial infarction;
primary percutaneous transluminal coronary angioplasty
- MeSH:
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
- From:Korean Journal of Nuclear Medicine
2003;37(4):219-228
- CountryRepublic of Korea
- Language:English
-
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.
