Relationships between Myocardial Perfusion, Myocardial Necrosis, and Technetium‐99m Pyrophosphate Uptake in Dogs Subjected to Sudden Coronary Occlusion
Relationships between Myocardial Perfusion, Myocardial Necrosis, and Technetium‐99m Pyrophosphate Uptake in Dogs Subjected to Sudden Coronary Occlusion
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突发冠状动脉闭塞犬心肌灌注、心肌坏死和锝-99m焦磷酸盐摄取之间的关系
DOI：
10.1161/01.cir.54.4.647
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发表时间：
1976
期刊：
影响因子：
37.8
通讯作者：
F. Abboud
中科院分区：
文献类型：
--
作者：
M. Marcus;R. Tomanek;J. Ehrhardt;R. Kerber;D. D. Brown;F. Abboud
总结：锝-99 mTc-PYP（99 mTc-PYP）梗塞磁图异常与心肌梗塞面积之间的定量关系尚不清楚。我们评估了9 wmTc-PYP蓄积的两个可能决定因素：用7-10 μ微球测量的心肌灌注和组织学确定的坏死程度。血流动力学和心肌灌注到左心室的小部分之前，5-10分钟，44 - 48小时后突然闭塞的左前降支冠状动脉在10条清醒的狗。第三次注射后静脉注射99 mTc-PYP，2小时后处死动物。重要的发现如下：1）所观察到的心肌坏死程度与冠状动脉闭塞后5-10分钟的节段灌注之间存在密切关系; 2）节段心肌灌注是包含坏死区域的心肌节段蓄积ImTc-PYP的重要决定因素。虽然目前的数据排除了对节段坏死程度与该节段99 mTc-PYP蓄积之间关系的统计分析，但两者似乎并不相关，这一发现将阻碍使用99 mTc-PYP图像的强度来判断梗死面积。心电图上异常的分布可以提供梗塞面积的估计。然而，梗塞的几何形状和扫描设备的分辨能力在许多临床情况下将显著限制这一点。
SUMMARY The quantitative relationship between abnormalities seen on technetium-99m pyrophosphate (99mTc-PYP) infarct scintigrams and the size of the myocardial infarction is unclear. We evaluated two possible determinants of 9wmTc-PYP accumulation: myocardial perfusion measured with 7–10 μ microspheres and the extent of necrosis determined histologically. Hemodynamics and myocardial perfusion to small segments of the left ventricle were measured prior to, 5–10 min, and 44 48 hours following sudden occlusion of the left anterior descending coronary artery in ten awake dogs. 99mTc-PYP was injected i.v. following the third injection of microspheres and the animals were killed 2 hours later. The important findings were as follows: 1) there is a close relationship between the extent of myocardial necrosis observed and the perfusion of segments 5–10 min following coronary occlusion; and 2) that segmental myocardial perfusion is an important determinant of ImTc-PYP accumulation by myocardial segments which contain areas of necrosis. Although the present data preclude statistical analysis of the relationship between the level of necrosis in a segment and the accumulation of 99mTc-PYP by that segment, the two do not appear to be related, a finding which would discourage use of intensity of99mTc-PYP images for infarct size. The distribution of an abnormality on the scintigram may provide an estimate of infarct size. However, the geometry of the infarct and the resolving power of the scanning equipment will significantly limit this in many clinical situations.