Evaluation of left ventricular perfusion and regional wall motion in myocardial infarction. Using 201Tl myocardial SPECT and 99mTc-HSAD multigated cardiac blood pool emission computed tomography

In order to evaluate left ventricular regional wall motion and regional myocardial perfusion, 99mTc-HSAD multigated cardiac blood pool emission computed tomography (cardiac pool SPECT) and 201Tl myocardial SPECT (Tl) were performed on 12 patients with acute myocardial infarction (AMI), 6 patients had treated with only thrombolysis in group I and 6 patients had treated with thrombolysis and selective PTCA in group II, 17 patients with old myocardial infarction (OMI) in group III and 5 normal volunteers (controls). The relationship between left ventricular regional wall motion and regional myocardial perfusion was estimated. The relationship between % length shortening (%LS) by cardiac pool SPECT and %Tl uptake (%TU) was good (r=0.820) in group III. The value for %TU in segments of akinesia was low (35%) and in those of severe hypokinesia was higher (48%). In all phases, two groups showed significant relationships between %LS and %TU in groups I and II. The %TU was unchanged in the akinetic segment, the %LS changed to 30% in group I and the %LS changed to 49% in group II. If the %TU is more than 50% (AMI) or 40% (OMI), we would observe viable muscle. The combination of Tl and cardiac pool SPECT are useful for evaluating myocardial viability in the patients with AMI. (author)