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Cardiovascular Research 1998 38(1):91-97; doi:10.1016/S0008-6363(97)00316-7
© 1998 by European Society of Cardiology
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Copyright © 1998, European Society of Cardiology

Differential uptake of myocardial perfusion radiotracers in normal, infarcted, and acutely ischemic peri-infarction myocardium

Juan Cinca*, Amparo Garcia-Burillo, Ana Carreño, Juan Castell, Mark Warren, Jaume Candell-Riera, Ana Domingo and J Soler-Soler

Laboratorio de Cardiologiéa Experimental del Servicio de Cardiologiéa and Servicio de Medicina Nuclear, Hospital General Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain

* Corresponding author. Tel. (+34-3) 489 4031; Fax (+34-3) 274 6063; E-mail: jcinca@ar.vhebron.es

Objectives: We measured the uptake of technetium-99m tetrofosmin (99mTc) and thallium-201 (201Tl) in areas of healed transmural myocardial infarction and in regions of acute peri-infarction ischemia. Methods: Anesthetised pigs with a 1-month old transmural infarction elicited by permanent ligature of the left anterior descending (LAD) coronary artery below the first branch underwent one hour of proximal LAD occlusion followed by injection of Formula -tetrofosmin and Formula either in the left atrium (GI, n=19) or in the jugular vein (GII, n=6). Twelve other pigs (GIII) with a similar acute peri-infarction ischemia received Formula -tetrofosmin and Formula into the left ventricle during cardiocirculatory arrest to rule out the effect of coronary collaterals. Radiotracer counting was determined in samples from normal, acute ischemic and necrotic regions. Results: Uptake of Formula -tetrofosmin and Formula was greater in the infarct scar (median % of normal tissue: 20 for Formula and 8.6 for Formula in GI; 22 and 15 in GII) than in acute ischemic myocardium (3.2 and 2.5 in GI; 6.4 and 3.3 in GII). Radiotracer injection in arrested hearts (GIII) depicted a similar pattern (median % of injected dose: 6.2 for Formula and 10 for Formula in the scar; 2.3 and 4.0 in acute ischemia; and 2.9 and 3.5 in normal tissue). The infarcted region showed connective tissue and lack of viable myocardium. Conclusions: A 1-month old infarct scar with no viable myocardial tissue can take up significant fractions of Formula -tetrofosmin and Formula even in the absence of coronary collateral perfusion. Data suggest that the infarct scar can extract these radiotracers from the intraventricular blood.

KEYWORDS Myocardial infarction; Radioisotopes; Myocardial viability; Pigs


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