Measurement of myocardial infarct size by technetium pyrophosphate single-photon tomography

The primary determinant of prognosis after acute myocardial infarction (AMI) is the size of the acute infarct. The present study evaluates 46 patients with different infarct distributions and sizes to test the hypothesis that single photon emission computed tomography with technetium-99m pyrophospha...

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Veröffentlicht in:The American journal of cardiology 1984-12, Vol.54 (10), p.1231-1236
Hauptverfasser: Corbett, James R., Lewis, Samuel E., Wolfe, Christopher L., Jansen, Donald E., Lewis, Margaret, Rellas, James S., Parkey, Robert W., Rude, Robert E., Buja, L. Maximilian, Willerson, James T.
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container_end_page 1236
container_issue 10
container_start_page 1231
container_title The American journal of cardiology
container_volume 54
creator Corbett, James R.
Lewis, Samuel E.
Wolfe, Christopher L.
Jansen, Donald E.
Lewis, Margaret
Rellas, James S.
Parkey, Robert W.
Rude, Robert E.
Buja, L. Maximilian
Willerson, James T.
description The primary determinant of prognosis after acute myocardial infarction (AMI) is the size of the acute infarct. The present study evaluates 46 patients with different infarct distributions and sizes to test the hypothesis that single photon emission computed tomography with technetium-99m pyrophosphate (Tc-99m-PPi) and blood pool overlay allows measurements of AMI size that provide insight into prognosis irrespective of infarct location. Identical Tc-99m-PPi and ungated blood pool projections were acquired over 180° with a rotating gamma camera. Reconstructed sections were color-coded and superimposed for purposes of infarct localization. Areas of increased pyrophosphate uptake within myocardial infarcts were thresholded at 65% of peak activity. The blood pool was thresholded at 60% and subtracted so as to determine an endocardial border for the left ventricle. Using this method, myocardial infarcts weighed 2.5 to 81.2 g. The correlation of infarct mass with prognosis showed that patients without previous AMI and with acute infarcts that weighed more than 40 g had an increased frequency of death and congestive heart failure (p
doi_str_mv 10.1016/S0002-9149(84)80072-7
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Areas of increased pyrophosphate uptake within myocardial infarcts were thresholded at 65% of peak activity. The blood pool was thresholded at 60% and subtracted so as to determine an endocardial border for the left ventricle. Using this method, myocardial infarcts weighed 2.5 to 81.2 g. The correlation of infarct mass with prognosis showed that patients without previous AMI and with acute infarcts that weighed more than 40 g had an increased frequency of death and congestive heart failure (p &lt;0.001). The correlation of measured infarct mass with peak serum creatine kinase level was significant (r = 0.83, p &lt;0.001; y = 0.015x + 13.20). The correlation coefficients for anterior, inferior and nontransmural AMI were not significantly different from those for the entire group. 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Maximilian</creatorcontrib><creatorcontrib>Willerson, James T.</creatorcontrib><title>Measurement of myocardial infarct size by technetium pyrophosphate single-photon tomography</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>The primary determinant of prognosis after acute myocardial infarction (AMI) is the size of the acute infarct. The present study evaluates 46 patients with different infarct distributions and sizes to test the hypothesis that single photon emission computed tomography with technetium-99m pyrophosphate (Tc-99m-PPi) and blood pool overlay allows measurements of AMI size that provide insight into prognosis irrespective of infarct location. Identical Tc-99m-PPi and ungated blood pool projections were acquired over 180° with a rotating gamma camera. Reconstructed sections were color-coded and superimposed for purposes of infarct localization. Areas of increased pyrophosphate uptake within myocardial infarcts were thresholded at 65% of peak activity. The blood pool was thresholded at 60% and subtracted so as to determine an endocardial border for the left ventricle. Using this method, myocardial infarcts weighed 2.5 to 81.2 g. The correlation of infarct mass with prognosis showed that patients without previous AMI and with acute infarcts that weighed more than 40 g had an increased frequency of death and congestive heart failure (p &lt;0.001). The correlation of measured infarct mass with peak serum creatine kinase level was significant (r = 0.83, p &lt;0.001; y = 0.015x + 13.20). The correlation coefficients for anterior, inferior and nontransmural AMI were not significantly different from those for the entire group. In conclusion, tomographically determined infarct mass data correlate with subsequent clinical prognosis, and Tc-99m-PPi tomography with blood pool overlay is a safe and effective means of sizing infarcts in patients with AMI.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiology. 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Vascular system</topic><topic>Clinical Enzyme Tests</topic><topic>Coronary heart disease</topic><topic>Creatine Kinase - blood</topic><topic>Diphosphates</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - diagnosis</topic><topic>Prognosis</topic><topic>Statistics as Topic</topic><topic>Technetium</topic><topic>Technetium Tc 99m Pyrophosphate</topic><topic>Tomography, Emission-Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Corbett, James R.</creatorcontrib><creatorcontrib>Lewis, Samuel E.</creatorcontrib><creatorcontrib>Wolfe, Christopher L.</creatorcontrib><creatorcontrib>Jansen, Donald E.</creatorcontrib><creatorcontrib>Lewis, Margaret</creatorcontrib><creatorcontrib>Rellas, James S.</creatorcontrib><creatorcontrib>Parkey, Robert W.</creatorcontrib><creatorcontrib>Rude, Robert E.</creatorcontrib><creatorcontrib>Buja, L. 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Maximilian</au><au>Willerson, James T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Measurement of myocardial infarct size by technetium pyrophosphate single-photon tomography</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>1984-12-01</date><risdate>1984</risdate><volume>54</volume><issue>10</issue><spage>1231</spage><epage>1236</epage><pages>1231-1236</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>The primary determinant of prognosis after acute myocardial infarction (AMI) is the size of the acute infarct. The present study evaluates 46 patients with different infarct distributions and sizes to test the hypothesis that single photon emission computed tomography with technetium-99m pyrophosphate (Tc-99m-PPi) and blood pool overlay allows measurements of AMI size that provide insight into prognosis irrespective of infarct location. Identical Tc-99m-PPi and ungated blood pool projections were acquired over 180° with a rotating gamma camera. Reconstructed sections were color-coded and superimposed for purposes of infarct localization. Areas of increased pyrophosphate uptake within myocardial infarcts were thresholded at 65% of peak activity. The blood pool was thresholded at 60% and subtracted so as to determine an endocardial border for the left ventricle. Using this method, myocardial infarcts weighed 2.5 to 81.2 g. The correlation of infarct mass with prognosis showed that patients without previous AMI and with acute infarcts that weighed more than 40 g had an increased frequency of death and congestive heart failure (p &lt;0.001). The correlation of measured infarct mass with peak serum creatine kinase level was significant (r = 0.83, p &lt;0.001; y = 0.015x + 13.20). The correlation coefficients for anterior, inferior and nontransmural AMI were not significantly different from those for the entire group. In conclusion, tomographically determined infarct mass data correlate with subsequent clinical prognosis, and Tc-99m-PPi tomography with blood pool overlay is a safe and effective means of sizing infarcts in patients with AMI.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>6095634</pmid><doi>10.1016/S0002-9149(84)80072-7</doi><tpages>6</tpages></addata></record>
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subjects Adult
Aged
Biological and medical sciences
Cardiology. Vascular system
Clinical Enzyme Tests
Coronary heart disease
Creatine Kinase - blood
Diphosphates
Female
Heart
Humans
Male
Medical sciences
Middle Aged
Myocardial Infarction - diagnosis
Prognosis
Statistics as Topic
Technetium
Technetium Tc 99m Pyrophosphate
Tomography, Emission-Computed
title Measurement of myocardial infarct size by technetium pyrophosphate single-photon tomography
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