PET imaging early after successful thrombolysis revealed severely impaired myocardial tissue perfusion in 37% of patients, resulting in no recovery of left ventricular function at 3 months.
Cohort (n=30)
Does early myocardial tissue perfusion assessed by PET predict late recovery of left ventricular function in patients with acute myocardial infarction after successful thrombolysis?
PET imaging reveals that adequate myocardial tissue perfusion is required for functional recovery after successful thrombolysis in acute myocardial infarction.
BACKGROUND: Impaired tissue reperfusion after successful recanalization of an epicardial coronary artery has been documented both in animals and in patients with acute myocardial infarction. Whether this phenomenon can be demonstrated with positron emission tomography (PET) and whether it has an effect on late recovery of flow, metabolism, and function are unknown. METHODS AND RESULTS: Thirty patients with an acute myocardial infarction and TIMI flow grade 3 of the infarcted vessel at 90 minutes after thrombolytic therapy were studied. Within 24 hours after thrombolysis, at 5 days and at 3 months, myocardial blood flow was measured with 13NH3. 18FDG uptake was measured at 5 days. Radionuclide left ventricular angiograms were acquired at 5 days and at 3 months. In 11 patients (37%), regional myocardial flow was severely impaired ( 75% of normal) and showed preserved regional contractile function at 3 months. CONCLUSIONS: This study is the first demonstration with PET of impaired myocardial tissue perfusion in patients with an acute myocardial infarction after successful thrombolysis. Functional recovery of the reperfused myocardium is observed only when adequate tissue flow is restored. PET may be helpful in selecting patients in whom additional revascularization can improve recovery of left ventricular function.
Maes et al. (Sun,) conducted a cohort in Acute myocardial infarction (n=30). PET imaging was evaluated on Myocardial blood flow and left ventricular functional recovery. PET imaging early after successful thrombolysis revealed severely impaired myocardial tissue perfusion in 37% of patients, resulting in no recovery of left ventricular function at 3 months.