Circulation, Vol 80, 1277-1286, Copyright © 1989 by American Heart Association
RJ Gibbons, MS Verani, T Behrenbeck, PA Pellikka, MK O'Connor, JJ Mahmarian, JH Chesebro and FJ Wackers
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.
ARTICLES
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
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905.
This article has been cited by other articles:
 |
|
 |
|
  R Rubinshtein, T D Miller, E E Williamson, J Kirsch, R J Gibbons, A N Primak, C H McCollough, and P A Araoz Detection of myocardial infarction by dual-source coronary computed tomography angiography using quantitated myocardial scintigraphy as the reference standard Heart, September 1, 2009; 95(17): 1419 - 1422. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Carlsson, J. F.A. Ubachs, E. Hedstrom, E. Heiberg, S. Jovinge, and H. Arheden Myocardium at risk after acute infarction in humans on cardiac magnetic resonance quantitative assessment during follow-up and validation with single-photon emission computed tomography. J. Am. Coll. Cardiol. Img., May 1, 2009; 2(5): 569 - 576. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. T. Ortiz-Perez, J. Rodriguez, S. N. Meyers, D. C. Lee, C. Davidson, and E. Wu Correspondence between the 17-segment model and coronary arterial anatomy using contrast-enhanced cardiac magnetic resonance imaging. J. Am. Coll. Cardiol. Img., May 1, 2008; 1(3): 282 - 293. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Pereztol-Valdes, J. Candell-Riera, C. Santana-Boado, J. Angel, S. Aguade-Bruix, J. Castell-Conesa, E. V. Garcia, and J. Soler-Soler Correspondence between left ventricular 17 myocardial segments and coronary arteries Eur. Heart J., December 2, 2005; 26(24): 2637 - 2643. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Ndrepepa, A. Kastrati, M. Schwaiger, J. Mehilli, C. Markwardt, A. Dibra, J. Dirschinger, and A. Schomig Relationship Between Residual Blood Flow in the Infarct-Related Artery and Scintigraphic Infarct Size, Myocardial Salvage, and Functional Recovery in Patients with Acute Myocardial Infarction J. Nucl. Med., November 1, 2005; 46(11): 1782 - 1788. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Natanzon, A. H. Aletras, L.-Y. Hsu, and A. E. Arai Determining Canine Myocardial Area at Risk with Manganese-enhanced MR Imaging Radiology, September 1, 2005; 236(3): 859 - 866. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. C. Lapeyre III, E. Klodas, P. J. Rogers, L. J. Sinak, T. C. Hammell, M. K. O'Connor, and R. J. Gibbons Quantitation of Regional Ejection Fractions Using Gated Tomographic Imaging With 99mTc-Sestamibi Chest, March 1, 2005; 127(3): 778 - 786. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. Gibbons, U. S. Valeti, P. A. Araoz, and A. S. Jaffe The quantification of infarct size J. Am. Coll. Cardiol., October 19, 2004; 44(8): 1533 - 1542. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Ndrepepa, J. Mehilli, M. Schwaiger, H. Schuhlen, S. Nekolla, S. Martinoff, C. Schmitt, J. Dirschinger, A. Schomig, and A. Kastrati Prognostic Value of Myocardial Salvage Achieved by Reperfusion Therapy in Patients with Acute Myocardial Infarction J. Nucl. Med., May 1, 2004; 45(5): 725 - 729. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Kastrati, J. Mehilli, K. Schlotterbeck, F. Dotzer, J. Dirschinger, C. Schmitt, S. G. Nekolla, M. Seyfarth, S. Martinoff, C. Markwardt, et al. Early Administration of Reteplase Plus Abciximab vs Abciximab Alone in Patients With Acute Myocardial Infarction Referred for Percutaneous Coronary Intervention: A Randomized Controlled Trial JAMA, February 25, 2004; 291(8): 947 - 954. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Burns, R. J. Gibbons, Q. Yi, R. S. Roberts, T. D. Miller, G. L. Schaer, J. L. Anderson, S. Yusuf, and CORE Study Investigators The relationships of left ventricular ejection fraction, end-systolic volume index and infarct size to six-month mortality after hospital discharge following myocardial infarction treated by thrombolysis J. Am. Coll. Cardiol., January 2, 2002; 39(1): 30 - 36. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Sciagra, S. Sestini, L. Bolognese, G. Cerisano, P. Buonamici, and A. Pupi Comparison of Dobutamine Echocardiography and 99mTc-Sestamibi Tomography for Prediction of Left Ventricular Ejection Fraction Outcome After Acute Myocardial Infarction Treated with Successful Primary Coronary Angioplasty J. Nucl. Med., January 1, 2002; 43(1): 8 - 14. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Tanaka and T. Nakamura Time Course Evaluation of Myocardial Perfusion After Reperfusion Therapy by 99mTc-Tetrofosmin SPECT in Patients with Acute Myocardial Infarction J. Nucl. Med., September 1, 2001; 42(9): 1351 - 1358. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U. Sechtem Imaging myocardial area at risk and final infarct size Eur. Heart J. Suppl., June 1, 2001; 3(suppl_C): C36 - C46. [PDF]
|
|
|
|
 |
|
 A. Schomig, A. Kastrati, J. Dirschinger, J. Mehilli, U. Schricke, J. Pache, S. Martinoff, F.-J. Neumann, M. Schwaiger, and The Stent versus Thrombolysis for Occluded Coronar Coronary Stenting plus Platelet Glycoprotein IIb/IIIa Blockade Compared with Tissue Plasminogen Activator in Acute Myocardial Infarction N. Engl. J. Med., August 10, 2000; 343(6): 385 - 391. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P Chareonthaitawee, R J Gibbons, R S Roberts, T F Christian, and R Burns The impact of time to thrombolytic treatment on outcome in patients with acute myocardial infarction Heart, August 1, 2000; 84(2): 142 - 148. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Matsunari, U. Schricke, F. M. Bengel, H.-U. Haase, P. Barthel, G. Schmidt, S. G. Nekolla, A. Schoemig, and M. Schwaiger Extent of Cardiac Sympathetic Neuronal Damage Is Determined by the Area of Ischemia in Patients With Acute Coronary Syndromes Circulation, June 6, 2000; 101(22): 2579 - 2585. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Gibbons, T. D. Miller, and T. F. Christian Infarct Size Measured by Single Photon Emission Computed Tomographic Imaging With 99mTc-Sestamibi : A Measure of the Efficacy of Therapy in Acute Myocardial Infarction Circulation, January 4, 2000; 101(1): 101 - 108. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. A. M. Estes III and D. N. Salem Predictive Value of the Electrocardiogram in Acute Coronary Syndromes JAMA, February 24, 1999; 281(8): 753 - 754. [Full Text] [PDF]
|
|
|
|
|
|
D. Hasdai, R. J. Gibbons, D. R. Holmes Jr, S. T. Higano, and A. Lerman Coronary Endothelial Dysfunction in Humans Is Associated With Myocardial Perfusion Defects Circulation, November 18, 1997; 96(10): 3390 - 3395. [Abstract] [Full Text]
|
|
|
|
|
|
J. H. Chesebro Direct Thrombin Inhibition Superior to Heparin During and After Thrombolysis : Dose, Duration, and Drug Circulation, October 7, 1997; 96(7): 2118 - 2120. [Full Text]
|
|
|
|
|
|
R. Medrano, R. W. Lowry, J. B. Young, D. G. Weilbaecher, L. H. Michael, I. Afridi, Z.-X. He, J. J. Mahmarian, and M. S. Verani Assessment of Myocardial Viability With 99mTc Sestamibi in Patients Undergoing Cardiac Transplantation: A Scintigraphic/Pathological Study Circulation, September 1, 1996; 94(5): 1010 - 1017. [Abstract] [Full Text]
|
|
|
|
|
|
G. L. Schaer, L. J. Spaccavento, K. F. Browne, K. A. Krueger, D. Krichbaum, J. M. Phelan, W. O. Fletcher, C. L. Grines, S. Edwards, M. K. Jolly, et al. Beneficial Effects of RheothRx Injection in Patients Receiving Thrombolytic Therapy for Acute Myocardial Infarction: Results of a Randomized, Double-Blind, Placebo-Controlled Trial Circulation, August 1, 1996; 94(3): 298 - 307. [Abstract] [Full Text]
|
|
|
|
|
|
T. Simor, W.-J. Chu, L. Johnson, A. Safranko, M. Doyle, G. M. Pohost, and G. A. Elgavish In Vivo MRI Visualization of Acute Myocardial Ischemia and Reperfusion in Ferrets by the Persistent Action of the Contrast Agent Gd(BME-DTTA) Circulation, December 15, 1995; 92(12): 3549 - 3559. [Abstract] [Full Text]
|
|
|
|
|
|
E. T. Hasche, C. Fernandes, S. B. Freedman, and R. W. Jeremy Relation Between Ischemia Time, Infarct Size, and Left Ventricular Function in Humans Circulation, August 15, 1995; 92(4): 710 - 719. [Abstract] [Full Text]
|
|
|
|
|
|
V. Sansoy, D. K. Glover, D. D. Watson, M. Ruiz, W. H. Smith, J. P. Simanis, and G. A. Beller Comparison of Thallium-201 Resting Redistribution With Technetium-99m–Sestamibi Uptake and Functional Response to Dobutamine for Assessment of Myocardial Viability Circulation, August 15, 1995; 92(4): 994 - 1004. [Abstract] [Full Text]
|
|
|
|
|
|
T. D. Miller, T. F. Christian, M. R. Hopfenspirger, D. O. Hodge, B. J. Gersh, and R. J. Gibbons Infarct Size After Acute Myocardial Infarction Measured by Quantitative Tomographic 99mTc Sestamibi Imaging Predicts Subsequent Mortality Circulation, August 1, 1995; 92(3): 334 - 341. [Abstract] [Full Text]
|
|
|
|
 |
|
 R. M. Fleming, C. H. Rose, and K. M. Feldmann Comparing a High-Dose Dipyridamole SPECT Imaging Protocol with Dobutamine and Exercise Stress Testing Protocols Angiology, July 1, 1995; 46(7): 547 - 556. [Abstract] [PDF]
|
|
|
|
|
|
B. L. Zaret and F. J. Wackers Nuclear Cardiology- First of Two Parts N. Engl. J. Med., September 9, 1993; 329(11): 775 - 783. [Full Text]
|
|
|
|
|
|
R. J. Gibbons, D. R. Holmes, G. S. Reeder, K. R. Bailey, M. R. Hopfenspirger, B. J. Gersh, and The Mayo Coronary Care Unit and Catheterization La Immediate Angioplasty Compared with the Administration of a Thrombolytic Agent Followed by Conservative Treatment for Myocardial Infarction N. Engl. J. Med., March 11, 1993; 328(10): 685 - 691. [Abstract] [Full Text]
|
|
|
|
 |
|
 T. F. Christian, I. P. Clements, T. Behrenbeck, K. C. Huber, J. H. Chesebro, B. J. Gersh, and R. J. Gibbons Limitations of the Electrocardiogram in Estimating Infarction Size after Acute Reperfusion Therapy for Myocardial Infarction Ann Intern Med, February 15, 1991; 114(4): 264 - 270. [Abstract] [PDF]
|
|