After their first inferior myocardial infarction, 34 patients were studied by vectorcardiography, thallium-
201 planar scintigraphy and 360° data acquisition of single-photon emission computed tomography (SPECT).
In 24 patients, the diagnosis from thallium-201 planar scintigrams was the same as vectorcardiographic diagnosis.
However, in 32 patients, the diagnoses by vectorcardiography and SPECT were identical. This result indicates:
(1) thallium-201 SPECT images are better than planar scintigrams in detecting the infarcted location and correlate
closely with the vectorcardiographic diagnosis; (2) the 3-dimensional analysis of the SPECT images can supply
anatomical information to explain the 3-dimensional electrical activity of the vectorcardiogram; (3) since the vectorcardiogram
represents 3-dimensional electrical activity, it is clearly unsatisfactory to use planar thallium-201
images which represent, in 2 dimensions, a 3-dimensional structure to compare perfusion with electrical activity;
(4) islands of viable tissue within myocardial necrosis may be an important reserve of electrical activity. Therefore,
the contraction (healing) of necrotic tissue and the reactive hypertrophy of myocardial islands and the residual
myocardium after infarction may be the underlying mechanism of time-normalized electrocardiogram; a further
follow-up SPECT study may provide evidence to support this hypothesis.