Feasibility of tomographic 99mTc-hexakis-2-methoxy-2-methylpropyl-isonitrile imaging for the assessment of myocardial area at risk and the effect of treatment in acute myocardial infarction.
Feasibility of tomographic 99mTc-hexakis-2-methoxy-2-methylpropyl-isonitrile imaging for the assessment of myocardial area at risk and the effect of treatment in acute myocardial infarction.
复制标题
断层扫描 99mTc-hexakis-2-甲氧基-2-甲基丙基-异腈成像用于评估危险心肌区域和急性心肌梗死治疗效果的可行性。
作者：
Raymond J. Gibbons;M. Verani;T. Behrenbeck;P. Pellikka;Michael K. O'Connor;J. Mahmarian;J. Chesebro;F. Wackers
11例急性心肌梗死患者于发病后4h内及治疗后6~14d静脉注射新型心肌灌注放射性药物99mTc-hexakis-2-methoxy-2-methylpropyl-isonitrile。没有接受静脉溶栓治疗的5名急性心肌梗死患者接受了类似的放射性药物注射。在静脉注射后6小时内，由于没有再分布的TC-Sestamibi，因此可以用单光子发射计算机断层成像来评估给药时心肌灌注的分布。心肌低灌注区在原始图像上占左室壁面积的9%~68%，前壁明显大于下壁(P<0.01)。心肌低灌注区在最终图像上的范围从左心室的0%到63%不等，在前壁梗死区也更大(p<0.01)。对于前壁(r=-0.74)和下壁(r=-0.97)心肌梗死节段，最终低灌注区与静息晚期射血分数和晚期节段室壁运动积分呈负相关(r=-0.82)。与未接受溶栓治疗的患者相比，接受溶栓治疗的患者在最初和最终研究期间心肌低灌流程度显著减少(-13+/-11%，p<0.003)，而未接受溶栓治疗的患者心肌低灌流程度无显著增加(4+/-6%，p>0.5)。在急性心肌梗死患者中，断层扫描可以确定处于危险状态的低灌注心肌的数量。急性心肌梗死患者治疗前后心肌血流灌注的变化是一种很有前途的评价治疗效果的方法。
99mTc-hexakis-2-methoxy-2-methylpropyl-isonitrile (Tc-Sestamibi), a new myocardial perfusion radiopharmaceutical, was injected intravenously in 11 patients within 4 hours of the onset of acute myocardial infarction before treatment with intravenous tissue-type plasminogen activator and 6-14 days later. Five patients with acute myocardial infarction who did not receive intravenous thrombolytic therapy underwent a similar injection of radiopharmaceutical. The absence of redistribution of Tc-Sestamibi permitted imaging with single-photon emission computed tomography up to 6 hours after intravenous injection to assess the distribution of myocardial perfusion at the time of administration. The region of hypoperfused myocardium on the initial images varied widely from 9% to 68% of the left ventricle and was significantly greater in anterior than in inferior infarcts (p less than 0.01). The region of hypoperfused myocardium on the final images varied widely from 0% to 63% of the left ventricle and was also greater in anterior infarcts (p less than 0.01). The final hypoperfused region correlated (r = -0.82) with the late resting ejection fraction and with the late regional wall motion score in the infarct segment for both anterior (r = -0.74) and inferior (r = -0.97) infarcts. There was a significant decrease (-13 +/- 11%, p less than 0.003) in the extent of hypoperfused myocardium between the initial and final studies in the patients who received thrombolytic therapy compared with an insignificant increase (4 +/- 6%, p greater than 0.5) in the patients who did not receive thrombolytic therapy. Tomographic imaging with Tc-Sestamibi permits determination of the amount of hypoperfused myocardium "at risk" in acute myocardial infarction. The change in myocardial perfusion determined by Tc-Sestamibi before and after therapy in acute myocardial infarction is a promising tool for assessing treatment.
再灌注和非再灌注心肌梗死中铊 201 摄取的差异。
影响因子：
20.1
作者：
Melin,JA;Becker,LC;Bulkley,BH
通讯作者：
Bulkley,BH
急性心肌梗死溶栓治疗后冠状动脉内铊 201 闪烁扫描与 10 和 100 天静脉内铊 201 闪烁扫描比较。
影响因子：
24
作者：
Heller,GV;Parker,JA;Silverman,KJ;Royal,HD;Kolodny,GM;Paulin,S;Braunwald,E;Markis,JE
通讯作者：
Markis,JE