Thallium 201 kinetics in stunned myocardium characterized by severe postischemic systolic dysfunction.

Moore, Carl A.; Cannon, James M.; Watson, Denny D.; Kaul, Sanjiv

doi:10.1161/01.cir.81.5.1622

Cited by 66 publications

(10 citation statements)

References 67 publications

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“…An experimental study demonstrated that thallium-201 extraction was unaltered in the stunned myocardium. 9 However, in the present case persistent thallium-201 perfusion defects were observed on the images obtained soon after the onset of myocardial infarction. This finding indicates that acute ischemic insult can result in severe metabolic disturbance.…”

Section: Discussioncontrasting

confidence: 51%

A clinical feature of myocardial stunning associated with acute myocardial infarction

et al. 1994

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We report a case of myocardial stunning after acute myocardial infarction. In the hyperacute phase of myocardial infarction, the patient's coronary arteries showed normal features on coronary angiography during extensive ST-segment elevation observed on a standard 12-lead electrocardiogram and extensive akinesis observed on a left ventriculogram. Thallium-201 emission computed tomography revealed extensive perfusion abnormality. In the chronic phase, the perfusion abnormality was markedly improved. However, the electrocardiogram demonstrated poor R wave progression, and the left ventriculography revealed slight hypokinesis in the anterolateral wall. The acetylcholine provocation test disclosed coronary vasospasm of the left anterior descending coronary artery. About six months thereafter, left ventricular wall motion became completely normal and no poor R wave progression was observed on the electrocardiogram. The findings in this case indicate that myocardial stunning resulted from brief but sever ischemia due to vasospasm which led to cardiogenic shock, and that the recovery of findings for thallium-201 perfusion might be followed by those of electrocardiography and left ventriculography in the stunned myocardium.

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Section: Discussioncontrasting

confidence: 51%

A clinical feature of myocardial stunning associated with acute myocardial infarction

et al. 1994

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“…The computer automatically calculated wall thickness in 32 chords along the LV circumference ( Figure 3C). 15 The average thickening along the 32 chords represented global LV thickening. Average thickening within the operator defined regions of reduced thickening during ischemia were also automatically calculated.…”

Section: Analysis Of Echocardiographic Imagesmentioning

confidence: 99%

Mechanism of ischemic mitral regurgitation. An experimental evaluation.

et al. 1991

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Background. Papillary muscle dysfunction (PMD) has been implicated in the pathogenesis of ischemic mitral regurgitation (MR). We hypothesized that ischemic MR is not caused by PMD and/or dysfunction of the myocardial regions from where the papillary muscles arise but is related to reduction in global left ventricular (LV) function. To test this hypothesis, three groups of dogs were studied.Methods and Results. In group 1 dogs (n=8), varying degrees of regional and global LV

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“…The initial uptake of this tracer is dependent on flow but if flow is relatively uniform, the distribution of the tracer 20 to 30 min after injection is related to viability (31). ' ' IT1 has been the favored tracer of myocardial viability in nuclear medicine for over a decade, and its distribution characteristics have been extensively studied (32)(33)(34)(35)(36)(37).…”

Section: Introductionmentioning

confidence: 99%

The determination of myocardial viability using Gd‐DTPA in a canine model of acute myocardial ischemia and reperfusion

Pereira¹,

Prato²,

Wisenberg³

et al. 1996

Magnetic Resonance in Med

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The partition coefficient of Gd-DTPA was thought to vary with the amount of cellular membrane damage after an acute myocardial infarction. The relationship between the partition coefficient of Gd-DTPA (lambda) and the uptake of 201Tl (as a marker of tissue viability) was studied 2 h to 3 weeks after reperfusion of a 2-h occlusion to the left anterior descending coronary artery in a canine model. Gd-DTPA was infused as a bolus followed by a prolonged constant infusion, and this infusion protocol was optimized such that the concentration of Gd-DTPA was directly related to lambda. After this infusion, MR images of excised hearts showed regions of increased signal intensity corresponding to increased Gd-DTPA concentration. At all time points, lambda and 201Tl uptake were strongly negatively correlated indicating that lambda is an accurate indicator of myocardial viability. Furthermore, lambda in the infarcted regions was increased relative to normal regions after 2 h of reperfusion and stayed elevated up to 3 weeks. At all time points, lambda in the infarcted and normal regions were significantly different. As well, this data showed a trend that lambda in infarcted regions decreased monotonically from 1 day to 3 weeks. This trend was confirmed with MR imaging by examining the change in signal intensity of in vivo images from 4 days to 3 weeks in two animals. These results suggest that MRI with Gd-DTPA could be used to measure the extent of myocardial damage after an acute myocardial infarction.

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Thallium 201 kinetics in stunned myocardium characterized by severe postischemic systolic dysfunction.

Abstract: The hypothesis tested in this study was that despite the presence of severe postischemic myocardial dysfunction ("stunning")

Cited by 66 publications

References 67 publications

A clinical feature of myocardial stunning associated with acute myocardial infarction

A clinical feature of myocardial stunning associated with acute myocardial infarction

Mechanism of ischemic mitral regurgitation. An experimental evaluation.

The determination of myocardial viability using Gd‐DTPA in a canine model of acute myocardial ischemia and reperfusion

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