Pathologic basis of thallium-201 scintigraphic defects in patients with fatal myocardial injury

B. H. Bulkley, K. Silverman, M. L. Weisfeldt, R. Burow, M. Pond, L. C. Becker

Research output: Contribution to journalArticlepeer-review

Abstract

Using a quantitative, computer-aided circumferential profile technique, we have shown that thallium-201 scintigrams with large defects can identify a group of patients with a high mortality after acute myocardial infarction. To determine whether high-risk thallium scintigrams predict poor survival because of a critical loss of myocardium, we correlated infarct size in 24 autopsied patients with the extent of thallium defect in three views. Of 13 patients with large defects (computer score ≥ 7.0) eight (62%) had > 25% loss of left ventricular (LV) myocardium, but five (38%) had smaller infarcts (4-24% of LV myocardium), suggesting that part of the scintigraphic defect was related to ischemia without necrosis. Eight of nine patients with loss ≥ 25% LV myocardium had large defects. In 10 of 11 patients with small defects (computer score < 7.0), infarcts involved < 20% of LV myocardium. Although scintigrams with large defects predicted a critical loss of myocardium in over 60% of our patients, they included an important second group, in which the scintigraphic defect appeared to reflect a small infarct and a large surrounding area of reversibly ischemic myocardium.

Original languageEnglish (US)
Pages (from-to)785-792
Number of pages8
JournalCirculation
Volume60
Issue number4
DOIs
StatePublished - Jan 1 1979

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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