Author + information
- Received September 24, 1993
- Revision received July 21, 1994
- Accepted August 3, 1994
- Published online January 1, 1995.
- Carl T Lomboy, MD,
- Douglas S Schulman, MD, FACC∗,
- Howard P Grill, MD, FACC,
- Angel R Flores, MD,
- Judith E Orie, MD, FACC and
- Jerome E Granato, MD, FACC
- ↵∗Address for correspondence: Dr. Douglas S. Schulman, Medical College of Pennsylvania, Allegheny General Hospital, 320 E. North Avenue, Pittsburgh, Pennsylvania 15212.
Objectives. This study attempted to determine the utility of early rest—redistribution thallium-201 imaging in detecting residual myocardial viability after myocardial infarction.
Background. The early detection of myocardial viability after myocardial infarction would have clinical relevance.
Methods. Thirty-one patients with acute myocardial infarction had early (mean [±SD] 2 ± 1 day) rest—redistribution thallium-201 imaging followed by radionuclide and coronary angiography. Late studies included stress—redistribution—reinjection thallium-201 imaging or radionuclide angiography, or both. Viability was defined by the rest thallium-201 scan as an initial mild rest defect or any defect that demonstrated redistribution.
Results. Group 1 (n = 15) was predicted to have viable and Group 2 (n = 16) nonviable myocardium in the infarct zone. Group 1 patients were more likely to have a patent infarct-related artery (15 of 15 vs. 10 of 16, p < 0.03), higher initial ejection fraction (61 ± 12% vs. 53 ± 9%, p < 0.05), higher infarct wall motion score (p < 0.0001) and fewer abnormal thallium-201 segments (p < 0.0001). On follow-up studies, ejection fraction improved in Group 1 (from 57 ± 13% to 66 ± 10%, p < 0.05, n = 9) and deteriorated in Group 2 (from 53 ± 10% to 46 ± 8%, p < 0.05, n = 13). On late stress testing with thallium-201 reinjection, Group 1 patients had fewer abnormal segments (p < 0.03) and higher infarct zone counts during exercise (p < 0.05) and after reinjection (p < 0.05) than Group 2 patients.
Conclusions. If confirmed by larger studies, early rest—redistribution thallium-201 imaging may be a useful technique for identifying residual viability after myocardial infarction.
- Received September 24, 1993.
- Revision received July 21, 1994.
- Accepted August 3, 1994.