TY - JOUR
T1 - Primary angioplasty in myocardial infarction
T2 - Assessment of improved myocardial perfusion with technetium-99m isonitrile
AU - Behrenbeck, Thomas
AU - Pellikka, Patricia A.
AU - Huber, Kenneth C.
AU - Bresnahan, John F.
AU - Gersh, Bernard J.
AU - Gibbons, Raymond J.
PY - 1991
Y1 - 1991
N2 - Technetium-99m-hexakis-2-methoxy-2-isobutyl-isonitrile (techne-tium-99m isonitrile) is a new radiopharmaceutical compound that reflects myocardial perfusion. Its kinetics, especially its lack of redistribution after intravenous administration, permits the assessment of changes in myocardial perfusion without delay of therapy. Tomographic images at rest were obtained immediately and 6 to 10 days later in 17 consecutive patients undergoing successful primary angioplasty during their first transmural myocardial infarction. Thirteen patients had anterior infarction. The initial (acute) defect size before angioplasty of 48 ± 17% of the left ventricle decreased significantly (p < 0.0001) to 29 ± 19% on the late scans. There was no correlation between the time to therapy and the reduction in defect size. Twelve of the 17 patients, including 7 of the 11 patients treated after 4 h, demonstrated a definite reduction in the initial defect size. Eight patients with angiographically proved persistent coronary occlusion underwent a similar imaging sequence. The initial defect size in this group remained unchanged on the late scans (24 ± 16% versus 26 ± 18%, p = NS). Primary angioplasty is an effective approach toward salvaging myocardium; comparison with thrombolytic drug therapy must await the results of controlled clinical trials.
AB - Technetium-99m-hexakis-2-methoxy-2-isobutyl-isonitrile (techne-tium-99m isonitrile) is a new radiopharmaceutical compound that reflects myocardial perfusion. Its kinetics, especially its lack of redistribution after intravenous administration, permits the assessment of changes in myocardial perfusion without delay of therapy. Tomographic images at rest were obtained immediately and 6 to 10 days later in 17 consecutive patients undergoing successful primary angioplasty during their first transmural myocardial infarction. Thirteen patients had anterior infarction. The initial (acute) defect size before angioplasty of 48 ± 17% of the left ventricle decreased significantly (p < 0.0001) to 29 ± 19% on the late scans. There was no correlation between the time to therapy and the reduction in defect size. Twelve of the 17 patients, including 7 of the 11 patients treated after 4 h, demonstrated a definite reduction in the initial defect size. Eight patients with angiographically proved persistent coronary occlusion underwent a similar imaging sequence. The initial defect size in this group remained unchanged on the late scans (24 ± 16% versus 26 ± 18%, p = NS). Primary angioplasty is an effective approach toward salvaging myocardium; comparison with thrombolytic drug therapy must await the results of controlled clinical trials.
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U2 - 10.1016/S0735-1097(10)80101-9
DO - 10.1016/S0735-1097(10)80101-9
M3 - Article
C2 - 1825094
AN - SCOPUS:0025763475
SN - 0735-1097
VL - 17
SP - 365
EP - 372
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 2
ER -