Predictive value of indium-111 antimyosin uptake for improvement of left ventricular wall motion after thrombolysis in acute myocardial infarction

Vlies, B. Van; Baas, J.; Visser, Cees A.; Royen, E Van; Delemarre, Ben J.; Bot, Hans; Dunning, Arend J.

doi:10.1016/0002-9149(89)90451-7

Cited by 21 publications

(6 citation statements)

References 20 publications

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“…Functional improvement of salvaged myocardium, however, is time dependent, due to delayed restoration of contraction of stunned post-ischaemic myocardium [24]. Since early count density index is related to the ultimate degree of asynergy, a low value for count density index is capable to recognize patients who will exhibit wall motion improvement in the post-acute phase, as we reported recently [9]. Next to confirmation of presence and location of acute myocardial infarction, traditionally evaluated with other techniques, early Indium-Ill antimyosin scintigraphy may be a tool for assessment of ultimate local myocardial function.…”

Section: Discussionmentioning

confidence: 81%

“…1); by dividing average myocardial counts by average left lung counts a count density index was calculated [9,11].…”

Section: Administration Of Radiolabeled Tracer and Imagingmentioning

confidence: 99%

“…Although in most cases, for the definite diagnosis of acute myocardial infarction, this technique is only complementary to plasma enzyme measurements and etectrocardiographical changes, it provides the opportunity to visualize the extent of myocardial necrosis [9]. In addition myocardial Indium-ill antimyosin uptake, visually compared with uptake in liver and sternum, and related to local myocardial function, appeared to correlate well with the degree of regional wall motion impairment after acute myocardial infarction [10].…”

Section: Introductionmentioning

confidence: 99%

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Early Indium-111 antimyosin scintigraphy for assessment of regional wall motion asynergy on discharge after myocardial infarction

et al. 1990

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To assess the relation between early Indium-111 monoclonal antimyosin antibody scintigraphy and degree of regional asynergy on discharge, 38 patients with a first acute myocardial infarct were studied (18 anterior, 20 inferoposterior infarctions). In 21 patients thrombolytic therapy was administered. On the first day of myocardial infarction, 80 MBq Indium-111 Antimyosin was injected. Planar images, anterior, lateral and left anterior oblique, were made 24 hours later. Localized myocardial uptake was present in 37/38 patients, and was evaluated for Count Density Index (count density of infarct zone/left lung count density) in the left anterior oblique images, which displayed the infarct zone well. Regional asynergy on discharge was evaluated by cross-sectional echocardiography and defined mild (hypokinesia) or severe (akinesia or dyskinesia). Count density index was significantly lower in 15 patients with mild asynergy, compared with 22 patients with severe asynergy (1.61 +/- 0.25 vs. 2.42 +/- 0.40, p less than 0.001). This difference was present in both patient groups treated with or without thrombolysis. We conclude that early count density index, reflecting the amount of local necrosis, is highly correlated to the ultimate degree of wall motion impairment.

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Section: Discussionmentioning

confidence: 81%

“…1); by dividing average myocardial counts by average left lung counts a count density index was calculated [9,11].…”

Section: Administration Of Radiolabeled Tracer and Imagingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Early Indium-111 antimyosin scintigraphy for assessment of regional wall motion asynergy on discharge after myocardial infarction

et al. 1990

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“…In planar antimyosin studies, van Vlies et al [21] used a count density index (CDI; infarct zone of the heart/left lung). They found a direct correlation between CDI and regional wall motion abnormalities at hospital discharge: patients with only mild regional akinesia had a significantly lower CDI than those with severe akinesia [21]. Recently, Senior et al [32] studied 29 patients with AMI using a new 99mTc antimyosin Fab complex in comparison to rain antimyosin.…”

Section: Risk Stratificationmentioning

confidence: 99%

“…If labelled with radioisotopes [13,14], areas of myocardial necrosis may be evaluated with nuclear imaging. Radiolabelled antimyosin antibodies have been used for detection of myocardial necrosis in patients with myocarditis [15,16], cardiomyopathy [ 17] and myocardial infarction [18][19][20][21][22] as well as for detection of transplant rejection [23]. Previous studies have shown that myocardial infarct size can be accurately estimated from antimyosin planar [20,21] and single-photon emission tomography (SPET) studies [12,14,18,22] with high sensitivity and specificity.…”

Section: Introductionmentioning

confidence: 99%

Thallium and indium antimyosin dual-isotope single-photon emission tomography in acute myocardial infarction to identify patients at further ischaemic risk

Schoeder

Topp²,

Friedrich³

et al. 1994

Eur J Nucl Med

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Dual-isotope single-photon emission tomography (SPET) with indium-111 antimyosin and thallium-201 chloride was performed in 54 patients with acute myocardial infarction (AMI) to detect the location and extent of myocardial necrosis (antimyosin) and viable myocardium (201Tl). All patients underwent intravenous thrombolytic therapy with either streptokinase (1.5 million units/90 min) or tissue plasminogen activator (80 mg/90 min). Sensitivity in detecting MI was 91% (49/54 patients). With regard to dual-isotope SPET patterns, patients were divided into three groups: match, i.e. antimyosin uptake in segments with thallium defect (n = 8); mismatch, i.e. no uptake of either of the nuclides in corresponding segments (presence of perfusion abnormalities in the absence of antimyosin uptake) (n = 5); and overlap, i.e. thallium uptake in segments with uptake of antimyosin (n = 41). Coronary angiography and thallium exercise tests were performed in 40 and 45 patients, respectively, 5-14 days after MI. Exercise-induced ischaemia occurred in 66% of patients with overlap, 14% with match and 0% with mismatch (P < 0.05 for overlap vs other groups). If, however, major in-hospital complications (sudden cardiac death, severe arrhythmias; five overlap, three overlap in addition to match/mismatch, two match, two mismatch) were included in the statistical analysis, there was no significant difference between the three groups (P = NS). Thus, although the dual-isotope pattern "overlap" identifies a subgroup of patients with a substantial amount of residual viable tissue after MI and a high probability of exercise-induced ischaemia, this criterion is of limited value in assessing short-term prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)

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Antimyosin-Myokard-SPECT

Wieler¹,

Bickel²

1997

Single-Photon-Emissions-Computertomographie (SPECT) Des Herzens

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Predictive value of indium-111 antimyosin uptake for improvement of left ventricular wall motion after thrombolysis in acute myocardial infarction

Cited by 21 publications

References 20 publications

Early Indium-111 antimyosin scintigraphy for assessment of regional wall motion asynergy on discharge after myocardial infarction

Early Indium-111 antimyosin scintigraphy for assessment of regional wall motion asynergy on discharge after myocardial infarction

Thallium and indium antimyosin dual-isotope single-photon emission tomography in acute myocardial infarction to identify patients at further ischaemic risk

Antimyosin-Myokard-SPECT

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