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  • Title: Localization of post-infarction myocardial ischemia by 201Tl emission computed tomography.
    Author: Spielmann RP, Nienaber CA, Heinemann H, Montz R.
    Journal: Nuklearmedizin; 1985 Dec; 24(5-6):201-5. PubMed ID: 3879349.
    Abstract:
    In 41 patients with a history of a single myocardial infarction, the location of myocardial ischemia was studied by 201Tl emission computed tomography immediately and 3 h after intravenous dipyridamole. Distant ischemia was distinguished from periinfarctional ischemia by the presence of transient thallium defects in, or slow thallium washout from, myocardium not supplied by the infarct-related coronary artery. Distant ischemia occurred in 13 patients and was always accompanied by peri-infarctional ischemia. Peri-infarctional ischemia without distant ischemia was observed in 15 patients. The occurrence of distant ischemia was found to be dependent on the severity of stenosis in non-infarct coronary vessels. Twelve (86%) of 14 patients with non-infarct stenosis of 75% or greater had distant ischemia, but only 1 (4%) of 27 patients with non-infarct stenosis of less than 75%. In the presence of distant ischemia, peri-infarctional ischemia was in 11 patients (85%) of the patients with peri-infarctional ischemia only, incomplete obstruction of the infarct vessel was observed. It is concluded that, by the distinction between peri-infarctional and distant ischemia, the presence of significant stenosis in non-infarct vessels can be non-invasively predicted from tomographic thallium scintigraphy with dipyridamole.
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