Relation of left ventricular perfusion and wall motion with metabolic activity in persistent defects on thallium-201 tomography in healed myocardial infarction

• Published in: The American journal of cardiology Vol. 62; no. 4; pp. 202 - 208
• Main Authors: Tamaki, Nagara, Yonekura, Yoshiharu, Yamashita, Keiji, Senda, Michio, Saji, Hideo, Hashimoto, Tetsuo, Fudo, Tetsuro, Kambara, Hirofumi, Kawai, Chuichi, Ban, Toshihiko, Konishi, Junji
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.08.1988; Elsevier
• Subjects: Aged; Ammonia; Biological and medical sciences; Cardiology. Vascular system; Coronary Circulation; Coronary heart disease; Deoxyglucose - analogs & derivatives; Exercise Test; Female; Fluorodeoxyglucose F18; Heart; Heart - diagnostic imaging; Humans; Male; Medical sciences; Middle Aged; Myocardial Contraction; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - physiopathology; Myocardium - metabolism; Nitrogen Radioisotopes; Thallium Radioisotopes; Tomography, Emission-Computed; Radionuclide study; Human; Infarct; Radiodiagnosis; Scar; Cardiovascular disease; Coronary vessel; Coronary heart disease; Left ventricle; Left ventriculography; Perfusion; Myocardium; Hemodynamics; Left ventricle performance; Positron emission tomography; Dyskinesia
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(88)90212-3

Myocardial viability in persistent thallium (TI)-201 defect is a controversial subject. To assess metabolic activity in segments with persistent defect, stress TI-201 tomography and positron emission tomography using nitrogen-13 ammonia and fluorine-18 2-fluoro-deoxyglucose (FDG) were performed in 28 patients with healed myocardial infarction. The segments with TI-201 perfusion defect in electrocardiogram-determined infarcted areas were selected for assessment. Stress perfusion defect was detected in 61 segments by TI-201 tomography. Twenty-two patients (36%) showed transient defects with redistribution (group 1) and 39 showed persistent defects (group 2). Increase in FDG uptake was observed in 95% in group 1. Among group 2 patients, 15 segments (38%) showed an increase in FDG uptake (group 2A) while the remaining 24 (62%) did not have an increased uptake (group 2B). The decrease in nitrogen-13 ammonia perfusion was more severe in group 2B (−23 ± 7%) than in group 2A (−13 ±9%) (p <0.005) and group 1 (−10 ± 4%) (p <0.001). In addition, wall motion scores tended to be lower in group 2B (0.21 ± 0.71), compared with group 2A (0.67 ± 0.70) (p = 0.05) and group 1 (0.77 ± 0.60) (p 0.01). These data indicate that metabolic viability was observed in approximately 40% of the segments with persistent TI-201 defect. Preservation of regional perfusion and wall motion in these areas was similar to that in areas with transient TI-201 defect.