What question did this study set out to answer?

To determine whether the water-perfusable tissue index measured by dynamic oxygen-15 water PET can assess myocardial viability and predict contractile function recovery after acute myocardial infarction.

July 1, 1992Circulation

A new strategy for the assessment of viable myocardium and regional myocardial blood flow using 15O-water and dynamic positron emission tomography.

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Why the study?

Does the water-perfusable tissue index (PTI) assessed by PET predict improvement in regional wall motion after successful thrombolysis in patients with acute myocardial infarction?

Key Points

To determine whether the water-perfusable tissue index measured by dynamic oxygen-15 water PET can assess myocardial viability and predict contractile function recovery after acute myocardial infarction.
Conducted dynamic PET imaging using transmission, carbon-15 monoxide, and oxygen-15 water in 8 healthy volunteers, 15 patients with old myocardial infarction, and 11 patients after successful thrombolysis for acute myocardial infarction.
Assessed systolic wall thickening by two-dimensional echocardiography within 2 to 4 days of infarction and at 4-month follow-up.
Quantified myocardial blood flow to perfusable tissue and compared the water-perfusable tissue index against fluorine-18 fluorodeoxyglucose metabolic imaging.
In old myocardial infarction, segments with preserved metabolism (ratio ≥1.20) had significantly higher water-perfusable tissue index values (0.75 ± 0.14 g/g) than irreversibly injured segments (0.53 ± 0.12 g/g, p < 0.01).
In acute myocardial infarction, segments exhibiting 4-month functional recovery had a baseline water-perfusable tissue index of 0.88 ± 0.10 g/g versus 0.53 ± 0.11 g/g in nonrecovering segments, while myocardial blood flow did not differ significantly between them.

Structured PICO

Does the water-perfusable tissue index (PTI) assessed by PET predict improvement in regional wall motion after successful thrombolysis in patients with acute myocardial infarction?

Population

34 subjects including healthy volunteers (n=8), patients with old myocardial infarction (OMI) (n=15), and patients successfully thrombolysed after an acute myocardial infarction (AMI) (n=11).

Intervention

Water-perfusable tissue index (PTI) assessment using 15O-water and dynamic positron emission tomography (PET).

Comparator

18FDG metabolic imaging (in OMI patients) and comparison between recovery versus nonrecovery segments (in AMI patients).

Outcome

Improvement in regional wall motion (systolic wall thickening) measured by two-dimensional echocardiography at 4 months.surrogate

The water-perfusable tissue index (PTI) measured by 15O-water PET is a promising marker of myocardial viability that predicts contractile recovery after AMI without requiring metabolic imaging.

Discussion

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Implication

PTI was higher in recovering segments after AMI; supports viability assessment but remains hypothesis-generating pending randomized evidence.

Cite This Study

Yamamoto et al. (1992) studied this question.

synapsesocial.com/papers/6a71d8d12163a0a01bc5cf90 https://doi.org/10.1161/01.cir.86.1.167

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Implication

PTI was higher in recovering segments after AMI; supports viability assessment but remains hypothesis-generating pending randomized evidence.

A new strategy for the assessment of viable myocardium and regional myocardial blood flow using 15O-water and dynamic positron emission tomography.

Key Points

Structured PICO

Discussion

Implication

Cite This Study

A new strategy for the assessment of viable myocardium and regional myocardial blood flow using 15O-water and dynamic positron emission tomography.

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

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