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European Heart Journal 1997 18(6):954-962;
Copyright © 1997 by the European Society of Cardiology.
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© 1997 The European society of Cardiology

Importance of flow/metabolism studies in predicting late recovery of function following reperfusion in patients with acute myocardial infarction

A. Maes*, L. Mortelmans*,, J. Nuyts*, G. Bormans*, M. C. Herregods{dagger}, B. Bijnens{dagger} and F. Van de Werf{dagger}

*Department of Nuclear Medicine UZ Gasthuisberg, Leuven, Belgium
{dagger}Department of Cardiology UZ Gasthuisberg, Leuven, Belgium

Received 7 January 1997; accepted 8 January 1997.

Correspondence: Prof. L Mortelmans, Dept. of Nuclear Medicine, UZ Gasthuisberg. Herestraat 49, 3000 Leuven. Belgium

Abstract

AIMS: Positron emission tomographic imaging is known to be a reliable indicator of viable myocardium in chronic heart disease. Its value in acute myocardial infarction has not been studied extensively.

METHODS AND RESULTS: Sixty-two patients receiving thrombolytic therapy were studied. Myocardial tissue flow and metabolism were measured at 5 days and 3 months. Recovery of left ventricular function was investigated with echocardiography or radionuclide ventriculography. In eight patients, normal flow was found in the infarct area at 5 days with no significant changes in flow, metabolism or function over the next 3 months. In 54 patients, impaired regional myocardial blood flow in the infarct zone was observed at 5 days. In 39 patients, there was a matching positron emission tomographic pattern, while in 15 the pattern was mismatched. None of the patients with a TIMI flow grade <3 revealed recovery of left ventricular function. In seven out of 11 patients with TIMI 3 flow and a mismatching pattern, additional angioplasty was performed with functional improvement in six.

CONCLUSIONS: Recovery of ventricular function is exclusively found in patients with a TIMI flow grade 3. Patients with a positron emission tomographic mismatching pattern reveal functional recovery only after subsequent angioplasty

Key Words: Myocardial infarction • thrombolysis • positron emission tomography • viability • stunning • functional recovery


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