Value of Nuclear Imaging Techniques in Determining Reperfusion Effects in Acute Myocardial Infarction

The aim of the study was to assess the value of myocardial perfusion scintigraphy (MPS) with 99m-Tc tetrofosmin to determine the salvaged myocardial tissue after reperfusion procedures in patients with acute myocardial infarction (AMI). The study group consisted of 25 patients (7 female, 18 male , mean age 57. 1 ± 2.0 years) who were admitted to the hospital within 12 hours of onset of AMI. On admission, 10 mCi 99m-Tc tetrofosmin was given and coronary angiography (CAG) was performed to all patients. Reperfusion procedures applied to 17 patients were either thrombolytic therapy or thrombolytic therapy with percutaneous transluminal coronary angioplasty (PTCA), whereas reperfusion was not applied to 8 patients. MPS was performed to all patients within an average of 3.1±0.3 hours following the tetrofosmin injection. Control CAGs were performed 24-48 hours later and MPS were repeated on 12-26 days of the AMI. Localization of the AMI was inferior in 17, anterior in 8 and the infarct-related artery was left anterior descending artery in 8, circumflex artery in 6 and right coronary artery in 11 patients. By means of control CAGs it was deduced that in 4 of the 17 patients who received thrombolytic therapy, (PTCA was performed 6 of them) and in 3 of the 8 patients who received no reperfusion procedures the infaret-related artery was not patent. Salvage index was 14.2% in patients who received trombolytic therapy and 0.7% in the other group. Therefore MPS with 99mTc tetrofosmin is a valuable method to show the benefits of reeanalization.