Key result
In patients with reperfused acute myocardial infarction, 100% of microvascular obstruction segments with wall motion improvement at follow-up had 99m-Tc PYP uptake, compared to only 21% of segments without improvement (P=0.001).
Why the study?
Does 201-Tl and 99m-Tc PYP dual SPECT predict wall motion improvement in microvascular obstruction regions after reperfused acute MI?
Observational (n=14)
No
Does 201-Tl and 99m-Tc PYP dual SPECT predict wall motion improvement in microvascular obstruction regions after reperfused acute MI?
Answers are grounded in this paper and cite their sources.
Dual SPECT with 201-Tl and 99m-Tc PYP can predict functional recovery of microvascular obstruction regions detected by CMR after reperfused acute myocardial infarction.
BACKGROUND: Few studies have compared the ability of cardiac magnetic resonance (CMR) with that of scintigraphy using 201-thallium (201-Tl) and 99m-technetium pyrophosphate (99m-Tc PYP) to evaluate microvascular obstructions (MOs). In the present study the relationship between the scintigraphic and CMR characteristics of MOs after acute myocardial infarction (MI) was examined. METHODS AND RESULTS: The 14 patients (age 69±8 years, 11 males) underwent 201-Tl/99m-Tc PYP SPECT 7±3 days, initial CMR 16±12 days, and follow-up CMR 193±20 days after a reperfused first acute MI. Each image was analyzed using a 17-segment model. Segmental extent of delayed enhancement (DE), wall motion (WM) and degree of 201-Tl uptake were scored in 238 segments. Of 91 MI segments, MO was recognized in 22 (25%) segments on CMR. WM was significantly better in proportion to 201-Tl uptake (P=0.01) in MO segments. All 8 MO segments with WM improvement at follow-up had 99m-Tc PYP uptake, although only 3 (21%) of 14 MO segments that did not show WM improvement at follow-up had 99m-Tc PYP uptake (P=0.001). CONCLUSIONS: 99m-Tc PYP and 201-Tl scintigraphy have the potential to predict WM status and improvement of the MO region after reperfused acute MI.
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Onishi et al. (2010) conducted an observational in Reperfused first acute myocardial infarction (n=14). 201-Tl and 99m-Tc PYP scintigraphy (dual SPECT) vs. Segments without uptake was evaluated on 99m-Tc PYP uptake in microvascular obstruction (MO) segments with versus without wall motion improvement at follow-up (p=0.001). In patients with reperfused acute myocardial infarction, 100% of microvascular obstruction segments with wall motion improvement at follow-up had 99m-Tc PYP uptake, compared to only 21% of segments without improvement (P=0.001).
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