Assessment of diagnostic value of technetium-99m pyrophosphate myocardial scintigraphy in 80 patients with possible acute myocardial infarction.

Walsh, Warren F.; Karunaratne, H B; Resnekov, Leon; Fill, H.; Harper, Paul V.

doi:10.1136/hrt.39.9.974

Cited by 18 publications

(4 citation statements)

References 22 publications

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“…As we shall see in subsequent sections, neither Blumgart (1926) nor Gorlin (1959) considered this to be so and a better understanding of their work might have saved Nuclear Cardiology decades of misdirection. However, the actual ability to detect infarction was not through the rest image obtained in this manner; but rather, a resting (Parkey 1976, Ahmad 1979, Walsh 1977 image obtained by using Tc-99m pyrophosphate (Tc-99 PYP), which required imaging of the heart within 48-72 hours of the time of infarction to accurately detect. Efforts to replace Tc-99m PYP with newer imaging agents (Khaw 1999) not only emphasize the limitations of timing and possible overlap of bone activity; but, the importance of utilization of resting images and not stress images to determine the presence or absence of damaged (infarction, stunned, hibernating) myocardium, as emphasized by Blumgart (1926) and Gorlin (1959).…”

Section: Discovering the Redistribution Properties Of Technetium-99m mentioning

confidence: 99%

Fleming-Harrington Redistribution Wash-in Washout (FHRWW): The Platinum Standard for Nuclear Cardiology

Fleming¹,

Harrington²

2011

Establishing Better Standards of Care in Doppler Echocardiography, Computed Tomography and Nuclear Cardiology

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Section: Discovering the Redistribution Properties Of Technetium-99m mentioning

confidence: 99%

Fleming-Harrington Redistribution Wash-in Washout (FHRWW): The Platinum Standard for Nuclear Cardiology

Fleming¹,

Harrington²

2011

Establishing Better Standards of Care in Doppler Echocardiography, Computed Tomography and Nuclear Cardiology

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“…In conclusion, the angular depen dency of IB allowed satisfactory differentiation between nontransmural and transmural myocardial infarction, although the amplitude of IB at a normal angle could not distinguish between the two groups. These findings suggest that quantitative analysis of the angle-dependence of ultrasonic backscatter offers considerable promise for cardiac tissue characterization.ferentiate between nontransmural and transmural myo cardial infarctions on the basis of the development of abnormal Q waves [1,2], It is also impossible to separate the two groups by other noninvasive techniques, includ ing technetium-99m pyrophosphate imaging [3,4] and …”

mentioning

confidence: 98%

Differentiation between Nontransmural and Transmural Myocardial Infarction Based on Quantitative Analysis of the Angle Dependence of Ultrasonic Backscatter

Kitabatake¹,

Shimazu²,

Nishioka³

et al. 1990

Am J Noninvas Cardiol

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This study tested the hypothesis that the angle-dependent nature of ultrasonic backscatter can differentiate nontransmural from transmural myocardial infarction. The relationship between the amplitude of integrated backscatter (IB) and the angle of incidence was studied in vitro with normal canine myocardium (n = 5) and infarcted myocardium 4 weeks after coronary ligation, including nontransmural (n = 5) and transmural infarcts (n = 2). A wide-band transducer was used (center frequency = 4.0 MHz). IB (dB) from the mid-portion of the myocardium was measured from a normal angle (0°) to 30° of incidence, by rotating a sample holder in 5° increments. Then the angular dependency of IB was determined as the slop (dB/degree) of a regression line plotted from IB versus the angle of incidence. IB was shown to be influenced by a function of the angle of incidence in all three groups. The amplitude of IB in nontransmural and transmural myocardial infarction was significantly greater than in normal myocardium over the range of angles studied (p < 0.01). However, IB at a normal angle could not distinguish nontransmural from transmural myocardial infarction (-43.2 ± 2.3 vs. -40.2 ± 4.0 dB, mean ± SD, p = NS). It became obvious that the angular dependency of IB could reliably distinguish nontransmural from transmural myocardial infarction (-0.189 ± 0.032 vs. -0.121 ± 0.012 dB/degree, p < 0.01). Furthermore, the angular dependency of IB in normal myocardium (-0.087 ± 0.024 dB/degree) was substantially smaller than in nontransmural (p < 0.01) or transmural myocardial infarction (p < 0.05). This analytic technique was highly reproducible. In conclusion, the angular dependency of IB allowed satisfactory differentiation between nontransmural and transmural myocardial infarction, although the amplitude of IB at a normal angle could not distinguish between the two groups. These findings suggest that quantitative analysis of the angle-dependence of ultrasonic backscatter offers considerable promise for cardiac tissue characterization.

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“…However, patients with nontransmural infarction exhibit inconsistent patterns of "mTc accumulation, ranging from poorly defined, diffuse accumulation to intense local uptake indistinguishable from that typical of transmural infarction. '2' 13 The sensitivity of 20'Tl scintigraphy for nontransmural infarction is also limited. '14' This study was performed to assess the sensitivity of PET compared with that of 201T1 scintigraphy and to characterize its value for delineating the extent, na-ture and anatomic distribution of injury with nontransmural compared with transmural myocardial infarction.…”

mentioning

confidence: 99%

Characterization of nontransmural myocardial infarction by positron-emission tomography.

Geltman¹,

Biello²,

Welch³

et al. 1982

Circulation

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SUMMARY The present study was performed to determine whether positron emission tomography (PET) performed after i.v. '1C-palmitate permits detection and characterization of nontransmural myocardial infarction. PET was performed after the i.v. injection of 1'C-palmitate in 10 normal subjects, 24 ture and anatomic distribution of injury with nontransmural compared with transmural myocardial infarction. Materials and Methods PatientsAll 56 subjects gave informed written consent. The group included 10 normal subjects (six males and four females, average age 39 years, range 23-68 years) and 46 patients who had survived acute myocardial infarction for at least 72 hours. Control subjects were seven normal volunteers without a history of chest pain or myocardial infarction and with normal physical examinations and three patients admitted to the coronary care unit for the evaluation of atypical chest pain in whom myocardial infarction was excluded based on serial electrocardiographic and enzymatic criteria. None of the controls had experienced previous myocardial infarction or exhibited Q waves on the ECG.The 46 patients (31 male, 15 female, mean age 57 years, range of 29-84 years) experienced myocardial infarction documented by a history of precordial chest pain of at least 20 minutes duration and serial elevations of total and MB plasma CK. Demographic data are summarized in table 1.Patients with myocardial infarction preceding the index episode were excluded. Transmural myocardial infarction was considered to be present if Q waves of 30 msec duration were seen in recordings from at least two concordant leads. In the absence of these criteria, nontransmural myocardial infarction was considered to be present. Infarction was transmural in 22 and nontransmural in 24 patients. Radiochemicals and Tomographic ProceduresThe "IC-palmitate was prepared with a synthesis developed at Washington University that involves the addition of "CO2 produced in the medical center cyclotron to a Grignard reagent (I-MgBr-pentade-

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Assessment of diagnostic value of technetium-99m pyrophosphate myocardial scintigraphy in 80 patients with possible acute myocardial infarction.

Cited by 18 publications

References 22 publications

Fleming-Harrington Redistribution Wash-in Washout (FHRWW): The Platinum Standard for Nuclear Cardiology

Fleming-Harrington Redistribution Wash-in Washout (FHRWW): The Platinum Standard for Nuclear Cardiology

Differentiation between Nontransmural and Transmural Myocardial Infarction Based on Quantitative Analysis of the Angle Dependence of Ultrasonic Backscatter

Characterization of nontransmural myocardial infarction by positron-emission tomography.

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