Cardiology pp 525-533 | Cite as

Quantitative Assessment of Infarct Size and its Influence by Thrombolysis

  • Burton E. Sobel
  • Edward M. Geltman
  • Steven R. Bergmann

Abstract

Conventional nuclear cardiology employs gamma-emitting tracers such as technetium-99 (99mTc) or thallium-201 (20lT1). Such tracers are not physiological metabolites and accordingly behave somewhat differently from the physiological constituents being traced. Single-photon emitters decay by liberating energy in the form of photons characteristic of the parent radio-nuclide, much of which is absorbed (attenuated) before it reaches the detector. Because of the variability of attenuation it is difficult, if not impossible, to accurately define both the amount of radiation emitted and its location. Thus, even though the reconstructed images may be aesthetically satisfying, quantitative limitations preclude definitive correspondence between the reconstructed image and the actual distribution of tracer in the organ of interest in absolute terms.1

Keywords

Positron Emission Tomography Infarct Size Myocardial Metabolism Tomographic Study Ischemic Zone 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    M. M. Ter-Pogossian, Limitations of present radionuclide methods in the evaluation of myocardial ischemia and infarction, Circulation 53:Suppl. 1:119 (1976).Google Scholar
  2. 2.
    E. S. Weiss, B. A. Siegal, B. E. Sobel, M. J. Welch, and M. M. Ter-Pogossian, Evaluation of myocardial metabolism and perfusion with positron-emitting radionuclides, Prog. Cardiovasc. Dis. 20:191 (1977).PubMedCrossRefGoogle Scholar
  3. 3.
    R. A. Lerch, H. D. Ambros, S. R. Bergmann, M. J. Welch, M. M. Ter-Pogossian, and B. E. Sobel, Localization of viable, ischemic myocardium by positron emission tomography (PET) with 11C—palmitate, Circulation 64:689 (1981).PubMedCrossRefGoogle Scholar
  4. 4.
    E. S. Weiss, E. J. Hoffman, M. E. Phelps, M. J. Welch, P. D. Henry, M. M. Ter-Pogossian, and B. E. Sobel, External detection and visualization of myocardial ischemia with 11C—subtrates in vitro and in vivo, Circ. Res. 39:24 (1976).PubMedCrossRefGoogle Scholar
  5. 5.
    M. S. Klein, R. A. Goldstein, M. J. Welch, and B. E. Sobel, External assessment of myocardial metabolism with ( 11C ) palmitate in rabbit hearts, Am J Physiol: Heart Circ. Physiol. 237:H51 (1979).Google Scholar
  6. 6.
    R. A. Lerch, S. R. Bergmann, H. D. Ambos, M. J. Welch, M. M. Ter-Pogossian, and B. E. Sobel, Effect of flow independent reduction of metabolism on regional myocardial clearance of 11C—palmitate, Circulation 65:731 (1982).PubMedCrossRefGoogle Scholar
  7. 7.
    E. S. Weiss, S. A. Ahmed, M. J. Welch, J. R. Williamson, M. M. Ter-Pogossian, and B. E. Sobel, Quantification of infarction in cross sections of canine myocardium in vivo with positron emission transaxial tomography and 11C—palmitate, Circulation 55:66 (1977).PubMedCrossRefGoogle Scholar
  8. 8.
    B. E. Sobel, E. S. Weiss, M. J. Welch, B. A. Siegel, and M. M. Ter-Pogossian, Detection of remote myocardial infarction in patients with positron emission transaxial tomography and intravenous 11C—palmitate, Circulation 55–853 (1977).PubMedCrossRefGoogle Scholar
  9. 9.
    K. A. A. Fox, H. Nomura, B. E. Sobel, and S. R. Bergmann, Constant radiolabeled palmitate consumption despite reduced flow in isolated hearts performing constant work, Clin Res. 30:186A (1982)(abstract).Google Scholar
  10. 10.
    R. A. Goldstein, M. S. Klein, M. J. Welch, and B. E. Sobel, External assessment of myocardial metabolism with C-11 palmitate in vivo. J. Nucl. Med. 21:342 (1980).PubMedGoogle Scholar
  11. 11.
    M. M. Ter-Pogossian, M. S. Klein, J. Markham, R. Roberts, and B. E. Sobel, Regional assessment of myocardial metabolic integrity in vivo by positron emission tomography with 11C—labelled palmitate, Circulation 61:242 (1980).PubMedCrossRefGoogle Scholar
  12. 12.
    R. K. Kordenat, and P. Kezdi, Experimental intracoronary thrombosis and selective in situ lysis by catheter technique, Am J. Cardiol. 30:640 (1972).PubMedCrossRefGoogle Scholar
  13. 13.
    P. B. Corr, J. A. Shayman, J. B. Kramer, and R. J. Kipnis, Increased β-adrenergic receptors in ischemic cat myocardium; A potential mediator of electro-physiological derangements, J. Clin. Invest. 67:1232 (1981).PubMedCrossRefGoogle Scholar
  14. 14.
    S. R. Bergmann, R. A. Lerch, K. A. A. Fox, P. A. Ludbrook, M. J. Welch, M. M. Ter-Pogossian, and B. E. Sobel, The temporal dependence of beneficial effects of coronary thrombolysis characterized by positron tomography, Am. J. Med. (in press).Google Scholar
  15. 15.
    E. M. Geltman, D. Biello, M. J. Welch, M. M. Ter-Pogossian, and B. E. Sobel, Characterization of nontransmural myocardial infarction by positron emission tomography, Circulation65:747 (1982).PubMedCrossRefGoogle Scholar
  16. 16.
    B. E. Sobel, and S. R. Bergmann, Coronary thrombolysis: Some unresolved issues, Am J. Med. 72:1 (1982).PubMedCrossRefGoogle Scholar
  17. 17.
    Unstable angina pectoris: National cooperative study group to compare surgical and medical therapy. II In-hospital experience and initial follow-up results in patients with one, two and three vessel disease, Am J. Cardiol. 42:839 (1978)CrossRefGoogle Scholar
  18. 18.
    G. F. Bresnahan, R. Roberts, W. E. Shell, J. Ross, Jr. and B. E. Sobel, Deleterious effects due to hemorrhage after myocardial reperfusion, Am J. Cardiol. 33:82 (1974).PubMedCrossRefGoogle Scholar
  19. 19.
    V. S. Mathur, G. A. Guinn, and W. H. Burris, Maximal revascularization (reperfusion) in intact conscious dogs after 2 to 5 hours of coronary occlusion, Am J. Cardiol. 36:252 (1975)PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1984

Authors and Affiliations

  • Burton E. Sobel
    • 1
  • Edward M. Geltman
    • 1
  • Steven R. Bergmann
    • 1
  1. 1.Cardiovascular DivisionWashington University School of MedicineSt. LouisUSA

Personalised recommendations