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European Journal of Nuclear Medicine and Molecular Imaging

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01.03.2007 | Original article

Assessment of non-reperfused and reperfused myocardial infarction using diffusible or deposited radiolabelled perfusion imaging agents

verfasst von: L. M. Riou, A. Broisat, C. Lartizien, M. C. Toufektsian, S. Maitrejean, M. Janier, G. Vanzetto, D. Fagret, C. Ghezzi

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 3/2007

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Abstract

Purpose

Incomplete microvascular reperfusion is often observed in patients undergoing thrombolytic therapy or angioplasty for acute myocardial infarction and has important prognostic implications. We compared the myocardial uptake of diffusible (²⁰¹Tl) and deposited (^99mTcN-NOET) perfusion imaging agents in the setting of experimental infarction.

Methods

Rats were subjected to permanent coronary occlusion (OCC, n=10) or to 45-min occlusion and reperfusion (REP, n=17). Seven days later, the tracers were co-injected and the animals were euthanised 15 min (all ten rats in the OCC group and 12 rats in the REP group) or 120 min (five rats from the REP group, euthanised at this time point to evaluate any redistribution of the tracers: REP-RED group) afterwards. Infarct size determination and ^99mTcN-NOET/²⁰¹Tl ex vivo imaging were performed. Regional flow and tissue oedema were quantified using radioactive microspheres and ^99mTc-DTPA, respectively.

Results

^99mTcN-NOET and ²⁰¹Tl defect magnitudes were similar in OCC animals (0.11±0.01 vs 0.13±0.01). In REP animals, ²⁰¹Tl defect magnitude (0.25±0.02) was significantly lower than the magnitude of ^99mTcN-NOET and flow defects (0.14±0.03 and 0.17±0.01, respectively; p<0.05), despite the lack of ²⁰¹Tl redistribution (REP-RED animals). ^99mTc-DTPA indicated the presence of oedema in the reperfused area. Blood distribution studies showed that, unlike ^99mTcN-NOET, ²⁰¹Tl plasma activity was mostly unbound to plasma proteins.

Conclusion

^99mTcN-NOET and ²⁰¹Tl delineated the non-viable area in chronic non-reperfused and reperfused myocardial infarction. The significantly decreased ²⁰¹Tl defect in reperfused infarction was likely due to partial diffusion of the tracer from the plasma into the oedema present in the infarcted area. Deposited perfusion tracers might be better suited than diffusible agents for the assessment of regional flow following reperfusion of myocardial infarction.

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Titel: Assessment of non-reperfused and reperfused myocardial infarction using diffusible or deposited radiolabelled perfusion imaging agents
verfasst von: L. M. Riou
A. Broisat
C. Lartizien
M. C. Toufektsian
S. Maitrejean
M. Janier
G. Vanzetto
D. Fagret
C. Ghezzi
Publikationsdatum: 01.03.2007
Verlag: Springer-Verlag
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 3/2007
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-006-0230-3

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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