Multifactorial determination of201Thallium uptake of the heart: an experimental study concerning the influence of ventricular mass, perfusion and oxygen consumption

Strauer, B. E.; Burger, Sandrine; Büll, Ü.

doi:10.1007/bf01906735

Cited by 21 publications

(3 citation statements)

References 10 publications

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“…Because myocardial 2mT1 uptake also depends on myocardial blood flow [28], starting acquisition too early in patients with severe CAD may lead to suboptimal results due to insufficient delivery of 2°lT1 through a severely stenotic artery. Berger et al [29] demonstrated redistribution of 2°~T1 at rest by using planar scintigraphy in patients with angina.…”

Section: Limitations and Technical Considerationsmentioning

confidence: 99%

Comparison of thallium-201 single-photon emission tomography after rest injection and fluorodeoxyglucose positron emission tomography for assessment of myocardial viability in patients with chronic coronary artery disease

Altehoeter¹,

Dahl²,

Buell³

et al. 1994

Eur J Nucl Med

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This prospective study in 42 patients with chronic coronary artery disease and severe wall motion abnormalities (sWMA) on cineventriculography (24 patients with previous myocardial infarction; ejection fraction, 45% +/- 13%) was designed to compare myocardial thallium-201 uptake after rest injection and normalized fluorodeoxyglucose (18FDG) uptake (after oral glucose load) for assessment of a rest 201Tl protocol to evaluate myocardial viability. The left ventricle was divided into the supply territory of the left anterior descending coronary artery (LAD) and the lateral wall and posterior territory (inferior, posterior and posteroseptal segments) because of the high variability of left circumflex and right coronary artery supply territories. Segmental 201Tl uptake in single-photon emission tomography (SPET) and segmental normalized 18FDG uptake (13 segments per patient) showed a close linear relationship in the LAD territory (r = 0.79) and in the lateral wall (r = 0.77), while the correlation in the posterior territory was considerably lower (r = 0.52). 201Tl/18FDG concordance was defined as an 18FDG uptake exceeding 201Tl uptake by < 20%. Discordance was assumed if 18FDG exceeded 201Tl uptake by at least 20%. Concordant results were shown by 81% (439/541) of segments. In segments with severe 201Tl reduction (< or = 50% of peak, n = 78) discordance was observed in 10% of segments in the LAD territory and lateral wall (n = 62) and in 44% of segments in the posterior territory (n = 16).(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Limitations and Technical Considerationsmentioning

confidence: 99%

Comparison of thallium-201 single-photon emission tomography after rest injection and fluorodeoxyglucose positron emission tomography for assessment of myocardial viability in patients with chronic coronary artery disease

Altehoeter¹,

Dahl²,

Buell³

et al. 1994

Eur J Nucl Med

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“…Several groups have further investigated the effects of coronary vasodilation on 207T1 kinetics in canine preparations. Strauer et al 19 showed that the dipyridamoleenhanced 207T1 uptake in normal myocardium was independent of an increase in myocardial oxygen demand. Gould endocardial surface of the left ventricle.…”

Section: Discussionmentioning

confidence: 99%

Effects of dipyridamole-induced vasodilation on myocardial uptake and clearance kinetics of thallium-201.

Beller¹,

Holzgrefe²,

Watson³

1983

Circulation

105

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Myocardial thallium-201 (201T1) uptake and clearance after intravenous administration of dipyridamole (150 jig/kg) were determined in 12 open-chest anesthetized dogs with a partial coronary artery stenosis. 201TI (1.5 mCi) was injected intravenously and myocardial biopsy specimens were obtained 10 min, 60 min, and 2 hr after injection. Serial changes in 201.T1 activity in the normal zone and in the zone of partial stenosis were correlated with microsphere-determined regional blood flow and distal coronary pressure. Another nine dogs with equivalent stenosis not given dipyridamole before 201TI served as controls. In the 12 dogs given dipyridamole, 201TI activity at 10 min in the zone of stenosis was reduced to 42 ± 5% of initial normal zone activity (p < .001) and remained at 44 ± 3% of initial normal zone activity at 2 hr. There was a good correlation (.81) between the percent reduction in myocardial 201TI activity and the percent reduction of peak hyperemic flow as determined by measuring the percentage difference in peak coronary flow after a transient 10 sec occlusion under control and stenotic conditions. In contrast, 201TI clearance was rapid in the normal zone, with 201T1 activity decreasing to 55 ± 3% of initial normal zone activity by 2 hr. A redistribution pattern was produced because of the disparate clearance rates from hyperperfused and relatively hypoperfused myocardial regions. The relative 201TI defect decreased from 58% to 1 1% from 10 min to 2 hr. In the normal zone dipyridamole increased epicardial flow from 1.03 0.09 (SEM) to 3.52 0.36 ml/min/ g (p < .0001) and endocardial flow from 1. 19 ± 0.09 to 2.96 0.20 ml/min/g (p = .0001). In the zone of partial stenosis the increase in epicardial flow after dipyridamole was less marked (1.01 ± 0.10 to 1.55 + 0.15 ml/min/g; p = .009) and endocardial flow decreased (0. 84 + 0. 11 to 0.64 + 0.15 ml/ min/g; p = .04). Coronary perfusion pressure distal to the stenotic zone fell from 65 ± 3 to 50 ± 3 mm Hg after dipyridamole. In the nine control dogs with equivalent stenosis, 201TI uptake and washout were not significantly different in the stenotic zone compared with the normal zone. These data indicate that dipyridamole-induced vasodilation in the presence of a partial stenosis results in diminished uptake and delayed clearance compared with increased uptake and more rapid clearance in normally perfused myocardium producing an initial 201TI defect with delayed redistribution. Our data further demonstrate that the magnitude of the initial decrease in 201TI uptake after dipyridamole correlates well with the percent reduction in coronary flow relative to the peak hyperemic flow response. Circulation 68, No. 6, 1328No. 6, -1338No. 6, , 1983 SYMPTOM-LIMITED EXERCISE is routinely used in conjunction with thallium-201 (201T1) myocardial imaging for detection and evaluation of coronary artery disease. Adequate stress is essential, since coronary artery disease will reduce the reserve capacity of the stenotic vessel long before there is significant reduct...

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“…Only grouping for severity of dyssynergia has led, however, to a corresponding decrease in regional/°iT1 uptake (Buell et al 1976;Tamaki et al 1990). Z°IT1 does not exclusively reflect perfusion (Strauer et al 1978;Buell 1979) nor is it taken up actively under all conditions: Forman and Kirk (1984), in an acute animal model, found evidence that in reperfused ischaemic myocardium, the intramyocardial accumulation of 2°1T1 is predominantly a passive process and is independent of Na-K ATPase.…”

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confidence: 99%

PET reflections

Buell

1991

Eur J Nucl Med

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Letter to the editor PET reflectionsDear Sir, In a recent editorial (Ell 1990) you stated that compared to PET, "the standards in performance -at least as far as clinical usefulness is concerned -continue to diverge in favour of SPET. PET is a unique tool for research". You reviewed some recent examples for SPET/ PET performance in brain tumours, epilepsy, and myocardial viability. In order to avoid any misinterpretations which may arise from the editorial, the following comments are offered.

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Multifactorial determination of201Thallium uptake of the heart: an experimental study concerning the influence of ventricular mass, perfusion and oxygen consumption

Cited by 21 publications

References 10 publications

Comparison of thallium-201 single-photon emission tomography after rest injection and fluorodeoxyglucose positron emission tomography for assessment of myocardial viability in patients with chronic coronary artery disease

Comparison of thallium-201 single-photon emission tomography after rest injection and fluorodeoxyglucose positron emission tomography for assessment of myocardial viability in patients with chronic coronary artery disease

Effects of dipyridamole-induced vasodilation on myocardial uptake and clearance kinetics of thallium-201.

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