Contractile Reserve, Thallium-201 Reverse Redistribution and Mismatch Between Perfusion and Metabolism in Reperfused Infarct-related Myocardium With Delayed and Incomplete Functional Recovery

Akutsu, Yasushi; Kodama, Yukinobu; Nishimura, Hideki; Kinohira, Yukihiko; Li, Huiling; Yamanaka, Hideyuki; Kayano, Hiroyuki; Hamazaki, Yoko; Shinozuka, Akira; Kubo, Takashi

doi:10.1536/jhj.45.739

Cited by 6 publications

(3 citation statements)

References 14 publications

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“…The usefulness of intravenous dipyridamole cardiac stress testing with thallium-201 myocardial perfusion single photon emission computed tomography (Tl-201 SPECT) for the diagnosis of CAD has been supported by numerous clinical trials in evaluating the efficacy and safety of the method in physically normal or impaired individuals. [2][3][4][5][6] Therefore, in this study, we performed Tl-201 SPECT in clinically asymptomatic SCI patients without known heart disease to evaluate the prevalence of CAD in this population.…”

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confidence: 99%

Evaluating the Prevalence of Silent Coronary Artery Disease in Asymptomatic Patients With Spinal Cord Injury

Lee

et al. 2006

Int. Heart J.

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SUMMARYTo evaluate the prevalence of coronary artery disease (CAD) in patients with spinal cord injury (SCI), 47 clinically asymptomatic SCI patients received thallium-201 myocardial perfusion single photon emission computed tomography (Tl-201 SPECT) after dipyridamole administration for the diagnosis of CAD. There were 4 groups as follows; group 1: 13 patients with quadriplegia and complete SCI, group 2: 11 patients with quadriplegia and incomplete SCI, group 3: 11 patients with paraplegia and complete SCI, and group 4: 12 patients with paraplegia and incomplete SCI. There were no significant differences in sex distribution, ages, SCI duration, or CAD risk factors among the SCI patients in the 4 groups. All Tl-201 SPECT images were interpreted by the agreement of 2 experienced nuclear medicine physicians without prior knowledge of the patients' histories. A total of 30 of 47 (63.8%) SCI patients had abnormal Tl-201 SPECT findings. Among the 4 groups of SCI patients, those in groups 1 and 4 had the significantly highest and lowest prevalences of abnormal Tl-201 SPECT findings, respectively. We concluded that combined quadriplegia and complete SCI is an important CAD risk factor in SCI patients based on the objective evidence of intravenous dipyridamole cardiac stress testing with Tl-201 SPECT. (Int Heart J 2006; 47: 325-330) Key words: Spinal cord injury, Thallium-201 myocardial perfusion single photon emission computed tomography THERE is a cluster of multiple risk factors for coronary artery disease (CAD) among individuals with spinal cord injury (SCI), 1) but there is little information available on the prevalence of CAD in this population. SCI patients tend to have an increased percentage of body fat and have sedentary life styles. These individuals may not have symptoms despite significant CAD, partially due to their reduced level of activity. SCI patients often undergo rehabilitation programs, exercise training, metabolic testing, and surgical procedures without having their From the

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confidence: 99%

Evaluating the Prevalence of Silent Coronary Artery Disease in Asymptomatic Patients With Spinal Cord Injury

Lee

et al. 2006

Int. Heart J.

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“…[8][9][10][11] This also reflects a state brought about by continuing fatty acid metabolism impairment mainly due to persistent myocardial ischemia or memory imaging. 9,11) It has been suggested that these mechanisms are due to severe culprit lesions and infarct-related artery occlusion or stenosis, and a sustained tissuelevel perfusion injury and impaired myocardial reperfusion of the microvascular level in patients with no significant coronary artery stenosis.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between the Mismatch of 123I-BMIPP and 201Tl Myocardial Single-Photon Emission Computed Tomography and Autonomic Nervous System Activity in Patients With Acute Myocardial Infarction

et al. 2006

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SUMMARYThe purpose of this study was to elucidate the relationship between the mismatch of thallium-201(Tl) and iodine-123-beta-methyl-iodophenyl-pentadecanoic acid (BMIPP) myocardial single-photon emission computed tomography (SPECT) and autonomic nervous system activity in myocardial infarction (MI) patients. The subjects were 40 patients (34 males, 6 females) who underwent examinations by 123 I-BMIPP and 201 Tl myocardial SPECT imaging and 24-hour Holter monitoring within a 3-day period 3 weeks after the onset of their first MI. R-R intervals were analyzed every hour over a period of 24 hours by fast Fourier transformation (FFT). High frequency (HF) and low frequency (LF) were defined as markers of cardiac vagal activity in the former and the LF/HF ratio as sympathetic activity. Greater or more extensive decreases in the BMIPP image than that in the Tl image were defined as a positive mismatch. Patients were divided into positive and negative mismatch groups of 20 patients each.There were no significant differences between the 2 groups in age, sex, site of infarction, max CK (creatine kinase), max CK-MB, or left ventricular ejection fraction. The incidences of clinical signs suggesting residual myocardial ischemia were significantly greater in the positive than in the negative mismatch group (P < 0.05). The mean values for HF over the entire 24-hour period and over the 5-hour nocturnal period (0-5 AM) in the positive mismatch group were both significantly lower than those in the negative mismatch group (P < 0.001 in both groups). The 24-hour mean HF and mean nighttime HF in patients with signs of residual ischemia were both significantly lower than in those without signs of residual ischemia in the positive mismatch group (P < 0.05 in both groups).The mean LF/HF ratio for both the entire 24-hour and the nocturnal period in the positive mismatch group were significantly higher than those in the negative mismatch group (P < 0.001, P < 0.05, respectively). The daily profile of hourly HF measurements was significantly lower in the positive mismatch group than in the negative mismatch group (P < 0.02). The mean values of HF for 24-hour and 5-hour periods were significantly lower in patients with signs of residual ischemia in the positive mismatch group than in those with signs of residual ischemia in the negative mismatch group (P < 0.01, P < 0.02, respectively). There were no significant differences between the patients with From the

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“…This phenomenon can be explained by an excessive washout of Tl and Tc from the reperfused myocardium. Tl washout after reperfusion is well known as reverse redistribution 1. Washout of Tc agent is also reported in reperfused myocardium 2.…”

Section: Descriptionmentioning

confidence: 98%

Reverse redistribution pattern in rest Tl-201 and stress Tc-99m SPECT in patients undergoing coronary interventions

et al. 2014

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Contractile Reserve, Thallium-201 Reverse Redistribution and Mismatch Between Perfusion and Metabolism in Reperfused Infarct-related Myocardium With Delayed and Incomplete Functional Recovery

Cited by 6 publications

References 14 publications

Evaluating the Prevalence of Silent Coronary Artery Disease in Asymptomatic Patients With Spinal Cord Injury

Evaluating the Prevalence of Silent Coronary Artery Disease in Asymptomatic Patients With Spinal Cord Injury

Relationship Between the Mismatch of 123I-BMIPP and 201Tl Myocardial Single-Photon Emission Computed Tomography and Autonomic Nervous System Activity in Patients With Acute Myocardial Infarction

Reverse redistribution pattern in rest Tl-201 and stress Tc-99m SPECT in patients undergoing coronary interventions

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