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  • Title: 99mTc-tetrofosmin assessment of myocardial perfusion and viability in canine models of coronary occlusion and reperfusion.
    Author: Glover DK, Ruiz M, Koplan BA, Watson DD, Beller GA.
    Journal: J Nucl Med; 1999 Jan; 40(1):142-9. PubMed ID: 9935070.
    Abstract:
    UNLABELLED: The goal of this study was to determine whether 99mTc-tetrofosmin can assess regional flow heterogeneity when injected during sustained coronary artery occlusion and to estimate the degree of myocardial salvage and viability during coronary reperfusion. METHODS: In protocol 1, 99mTc-tetrofosmin, 201 TI and microspheres were injected during total left anterior descending (LAD) coronary artery occlusion in five anesthetized open-chested dogs. Protocol 2 dogs underwent LAD occlusion for either 60 min (n = 7) or 180 min (n = 6) followed by 105 min of reperfusion. 99mTc-tetrofosmin (10 mCi), 201TI (1 mCi) and microspheres were injected 90 min after reflow. In both protocols, myocardial 99mTc-tetrofosmin and 201TI activities were quantified from regions of interest on ex vivo images and by in vitro well counting. RESULTS: In protocol 1, there was a linear relationship between 201TI (r = 0.96) and 99mTc-tetrofosmin (r 0.92) activities and microsphere flow during the occlusion. In protocol 2, the LAD/left circumflex (LCx) defect count ratios for 99mTc-tetrofosmin and 201TI from images of myocardial slices were comparable in dogs undergoing either 1 or 3 h of LAD occlusion and 105 min of reperfusion. Similarly, the LAD/LCx in vitro count ratios were comparable between 201TI and 99mTc-tetrofosmin in 1 and 3 h occluded dogs, and significantly lower than the reperfusion flow when these tracers were injected. Uptake of both tracers was depressed to a greater extent in areas of severe ischemic damage. CONCLUSION: These data suggest that administration of 99mTc-tetrofosmin during coronary occlusion accurately delineates the flow heterogeneity. When given after reperfusion, 99mTc-tetrofosmin uptake was significantly reduced in reperfused, infarcted areas and was reflective of viability and the degree of myocardial salvage in addition to reperfusion flow. These experimental studies validate the clinical use of 99mTc-tetrofosmin for assessing persistent coronary artery occlusion, and infarct size and myocardial viability after reperfusion.
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