Evaluation of Salvaged Myocardium After Acute Myocardial Infarction Using Single Photon Emission Computed Tomography After ^<201>Tl-Glucose-Insulin Infusion

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Background GIK-^<201>Tl imaging reportedly improves the detection of viable myocardium, so the present study evaluated whether it can detect myocardial viability after acute myocardial infarction (AMI). Methods and Results Resting ^<201>Tl and ^<99m>Tc-pyrophosphate (PYP) dual single photon emission computed tomography (SPECT) and ^<201>Tl SPECT after ^<201>Tl with GIK (10% glucose, insulin 5U, and KCl 10mmol) infusion (GIK-^<201>Tl) were performed in 25 AMI patients within 10 days of admission. GIK-^<201>Tl SPECT images were obtained immediately and 4h after infusion. Left ventriculography (LVG) was performed within 3 weeks and at 6 months when follow-up ^<201>Tl SPECT was also performed. From 20 SPECT segments, both the summed defect score (RDS) and the number of defect segments (ES) were calculated. The infarcted area was defined as ^<99m>Tc-PYP uptake segments. Wall motion was estimated in 7 LVG segments. The ES of R-^<201>Tl (5.5±2.8), immediate GIK-^<201>Tl (4.0±2.3), and 4-h GIK-^<201>Tl (5.6±2.7) were lower than that of ^<99m>Tc-PYP (7.5±4.1) (p<0.05), and the ES had significantly declined 6 months later on ^<201>Tl (3.5±2.8) (p<0.05). Although the RDS of R-^<201>Tl (11.3±7.9) and 4-h GIK-^<201>Tl (11.2±6.3) were greater than at the 6-month ^<201>Tl (7.1±6.5), immediate GIK-^<201>Tl (7.4±6.5) was equivalent to follow-up ^<201>Tl. The sensitivity of immediate GIK-^<201>Tl was highest among the imaging methods. Conclusion To detect myocardial viability after AMI, early imaging with GIK-^<201>Tl is more useful than resting ^<201>Tl imaging.
2004-03-20

Evaluation of Salvaged Myocardium After Acute Myocardial Infarction Using Single Photon Emission Computed Tomography After ^<201>Tl-Glucose-Insulin Infusion

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