Transient defects on resting thallium scans in patients with coronary artery disease

Gewirtz, Henry; Strausś, H. William; Dinsmore, Robert E.; McKusick, Kenneth A.; Zir, Leonard M.; Pohost, Gerald M.

doi:10.1016/0002-9149(78)90294-1

The American Journal of Cardiology

1978

DOI: 10.1016/0002-9149(78)90294-1

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Transient defects on resting thallium scans in patients with coronary artery disease

Henry Gewirtz

H. William Strausś

Robert E. Dinsmore

et al.

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Cited by 22 publications

(23 citation statements)

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“…201 Tl] perfusion images could improve after revascularization 2 or with restredistribution 3 or reinjection. 4 To date, the molecular mechanisms underlying myocardial hibernation have remained elusive.…”

mentioning

confidence: 99%

Myocardial Hibernation

Sawyer

Loscalzo

2002

Circulation

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mentioning

confidence: 99%

Myocardial Hibernation

Sawyer

Loscalzo

2002

Circulation

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“…More recently, defect resolution has been observed in clinical situations where myocardial blood flow is persistently reduced during the serial imag-ing interval: (1) in patients with severe coronary artery disease and angina pectoris in the absence of clinical evidence of active ischemia and with presumed reductions in resting myocardial blood flow distal to severe stenoses (Gewirtz et al, 1979;Berger et al, 1979), (2) in patients with unstable angina even during pain-free intervals (Wackers et al, 1978), and (3) in patients with acute myocardial infarction (Smitherman et al, 1978). In this latter group, Tl-201 defects were reported to diminish in size inward from the periphery, and this was thought to be due to filling in of an ischemic periinfarction area.…”

mentioning

confidence: 99%

Thallium redistribution in dogs with severe coronary artery stenosis of fixed caliber.

Pohost¹,

Okada²,

O’Keefe³

et al. 1981

Circulation Research

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“…[1][2][3] Quantitative analysis of the scans in.these patients suggested that 201Tl uptake in hypoperfused, but presumably viable, regions played the dominant role in 201Tl redistribution. 3 4 If correct, the concept of delayed uptake of 201Tl into myocardial regions with subnormal coronary flow is important for two reasons.…”

mentioning

confidence: 90%

Gamma camera quantitation of thallium-210 redistribution at rest in a dog model.

Steingart¹,

Bontemps²,

Scheuer³

et al. 1982

Circulation

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tion in a dog model of sustained regional myocardial flow reduction at rest. Materials and MethodsMongrel dogs (average weight 22.5 kg) were premedicated with i.m. morphine sulfate (2 mg/kg), anesthetized with sodium pentobarbital (20 mg/kg) and mechanically ventilated through an endotracheal tube. Additional barbiturates were given whenever necessary. After a left thoracotomy, the proximal left circumflex coronary artery was dissected free (in the first two dogs) to allow placement of a circumferential flow probe, an occluder to produce intermittent zero flow and a distal constrictor. The purpose of this constrictor was to produce a sustained reduction of resting blood flow. In the next five dogs studied, the left anterior descending coronary artery was cannulated distal to its second major branch with an extracorporeal flow probe system connected to the right carotid artery. Flow reduction was adjusted by a screw clamp applied over the Silastic tubing just distal to its exit from the carotid artery. Such a system also allows pressure monitoring of the perfused coronary artery.'0 Intravascular catheters were then placed into the left atrium through its appendage for microsphere injection; into the right atrium for injection of indocyanine green dye (ICG); into the right femoral artery for recording ICG dilution curves (Gilford IR 103) and collecting arterial reference blood during the injection of microspheres; and into the descending thoracic aortic through the left femoral artery for pressure monitoring and collecting duplicate arterial reference blood during microsphere injection. A catheter in the femoral vein allowed infusion of fluid and injection of 201TI.After baseline coronary flow was recorded with the flowmeter, the left circumflex (first two dogs) or the extracorporeal line to the anterior descending coronary artery (next five dogs) was constricted so that resting flow was reduced and held steady. With the thoracotomy left open, the left lung pushed away from the heart and the heart suspended in a pericardial cradle. A gamma camera (Picker Nuclear) with an all-purpose collimator was positioned approximately 6 inches from the lateral surface of the heart and fixed there for the duration of the experiment.Two to three ICG dilution cardiac outputs were then determined. Two million to 4 million microspheres, 15 Am in diameter and labeled with 4"Sc diluted in 10 ml of 6% dextran and 2 drops of Tween, were ultrasonicated to ensure proper mixing. These were slowly injected (15 seconds) into the left atrium while dual reference arterial blood samples were collected (at 10 ml/min for 2 minutes) from the femoral artery and the descending thoracic aorta. Within 5 minutes of the microsphere injection, 1.5 mCi of 201T1 were flushed rapidly (1-2 seconds) into the femoral vein and continuous recording of gamma camera images was begun on a PDP 1134 computer (Digital Equipment Corporation). The computer was programmed to store the gamma camera data in a 64 X 64 pixel matrix in 30-second frames starting 1 minute afte...

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Transient defects on resting thallium scans in patients with coronary artery disease

Cited by 22 publications

References 0 publications

Myocardial Hibernation

Myocardial Hibernation

Thallium redistribution in dogs with severe coronary artery stenosis of fixed caliber.

Gamma camera quantitation of thallium-210 redistribution at rest in a dog model.

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