TY - JOUR
T1 - Relation of left ventricular volume and function over one year after acute myocardial infarction to infarct size determined by technetium-99m sestamibi
AU - Christian, Timothy F.
AU - Behrenbeck, Thomas
AU - Gersh, Bernard J.
AU - Gibbons, Raymond J.
N1 - Funding Information:
From the Division of Cardiovascular Diseasesa nd Internal Medicine, Mayo Clinic, Rochester, Minnesota. This study was supported in part by a grant from E.I. duPont DeNemours and Company North Biller&, Massachusetts.M anuscript received December 3 1, 1990;r evisedm an-uscript received March 4, 1991 , and acceptedM arch 6, 1991 . Address for reprints: Timothy F. Christian, MD, Mayo Clinic, 200 First Street, SW, Rochester,M innesota 55905.
PY - 1991/7/1
Y1 - 1991/7/1
N2 - Twenty patients with a first acute myocardial infarction (AMI) (15 anterior, 5 inferior) who received successful reperfusion therapy underwent tomographic imaging with technetium-99m (Tc-99m) sestamibi and radionuclide ventriculography at discharge, 6 weeks, and 1 year after AMI. Patency of the infarct-related artery after reperfusion (thrombolysis, 8 patients; coronary angioplasty, 12 patients) was confirmed by angiography in all patients. Tc-99m sestamibi perfusion defect at discharge (a measure of infarct size) was quantitated using previous methods and expressed as a percentage of the left ventricle (28 ± 19%, range 0 to 59%). This perfusion defect size correlated closely with ejection fraction at discharge (r = -0.87), 6 weeks (r = -0.81) and at 1 year (r = -0.78, all p < 0.0001). Perfusion defect size at discharge also correlated closely with end-systolic volume index at discharge (r = 0.71, p < 0.0005), 6 weeks (r = 0.63, p < 0.005) and at 1 year (r = 0.76, p < 0.0001). Perfusion defect size at discharge did not correlate significantly with end-diastolic volume index at discharge or at 6 weeks, but did correlate at 1 year (r = 0.66, p < 0.005). There was no significant group change in end-systolic or end-diastolic volume indexes from discharge to 1 year later, although 7 patients had definite individual changes in end-diastolic volume index (3 increased and 4 decreased). There was no relation between defect size and late changes in end-systolic volume index, but there was a weak correlation between defect size and late changes in end-diastolic volume index (r = 0.42, p = 0.07). Tc-99m sestamibi perfusion defect at discharge correlates with ejection fraction, and end-diastolic and endsystolic volume indexes 1 year after AMI. In most patients with patent infarct-related arteries after AMI, there does not appear to be a significant overall increase in ventricular volume during the first year after infarction.
AB - Twenty patients with a first acute myocardial infarction (AMI) (15 anterior, 5 inferior) who received successful reperfusion therapy underwent tomographic imaging with technetium-99m (Tc-99m) sestamibi and radionuclide ventriculography at discharge, 6 weeks, and 1 year after AMI. Patency of the infarct-related artery after reperfusion (thrombolysis, 8 patients; coronary angioplasty, 12 patients) was confirmed by angiography in all patients. Tc-99m sestamibi perfusion defect at discharge (a measure of infarct size) was quantitated using previous methods and expressed as a percentage of the left ventricle (28 ± 19%, range 0 to 59%). This perfusion defect size correlated closely with ejection fraction at discharge (r = -0.87), 6 weeks (r = -0.81) and at 1 year (r = -0.78, all p < 0.0001). Perfusion defect size at discharge also correlated closely with end-systolic volume index at discharge (r = 0.71, p < 0.0005), 6 weeks (r = 0.63, p < 0.005) and at 1 year (r = 0.76, p < 0.0001). Perfusion defect size at discharge did not correlate significantly with end-diastolic volume index at discharge or at 6 weeks, but did correlate at 1 year (r = 0.66, p < 0.005). There was no significant group change in end-systolic or end-diastolic volume indexes from discharge to 1 year later, although 7 patients had definite individual changes in end-diastolic volume index (3 increased and 4 decreased). There was no relation between defect size and late changes in end-systolic volume index, but there was a weak correlation between defect size and late changes in end-diastolic volume index (r = 0.42, p = 0.07). Tc-99m sestamibi perfusion defect at discharge correlates with ejection fraction, and end-diastolic and endsystolic volume indexes 1 year after AMI. In most patients with patent infarct-related arteries after AMI, there does not appear to be a significant overall increase in ventricular volume during the first year after infarction.
UR - http://www.scopus.com/inward/record.url?scp=0026328986&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0026328986&partnerID=8YFLogxK
U2 - 10.1016/0002-9149(91)90703-N
DO - 10.1016/0002-9149(91)90703-N
M3 - Article
C2 - 1829319
AN - SCOPUS:0026328986
SN - 0002-9149
VL - 68
SP - 21
EP - 26
JO - The American journal of cardiology
JF - The American journal of cardiology
IS - 1
ER -