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Assessment of non-reperfused and reperfused myocardial infarction using diffusible or deposited radiolabelled perfusion imaging agents

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Abstract

Purpose

Incomplete microvascular reperfusion is often observed in patients undergoing thrombolytic therapy or angioplasty for acute myocardial infarction and has important prognostic implications. We compared the myocardial uptake of diffusible (201Tl) and deposited (99mTcN-NOET) perfusion imaging agents in the setting of experimental infarction.

Methods

Rats were subjected to permanent coronary occlusion (OCC, n=10) or to 45-min occlusion and reperfusion (REP, n=17). Seven days later, the tracers were co-injected and the animals were euthanised 15 min (all ten rats in the OCC group and 12 rats in the REP group) or 120 min (five rats from the REP group, euthanised at this time point to evaluate any redistribution of the tracers: REP-RED group) afterwards. Infarct size determination and 99mTcN-NOET/201Tl ex vivo imaging were performed. Regional flow and tissue oedema were quantified using radioactive microspheres and 99mTc-DTPA, respectively.

Results

99mTcN-NOET and 201Tl defect magnitudes were similar in OCC animals (0.11±0.01 vs 0.13±0.01). In REP animals, 201Tl defect magnitude (0.25±0.02) was significantly lower than the magnitude of 99mTcN-NOET and flow defects (0.14±0.03 and 0.17±0.01, respectively; p<0.05), despite the lack of 201Tl redistribution (REP-RED animals). 99mTc-DTPA indicated the presence of oedema in the reperfused area. Blood distribution studies showed that, unlike 99mTcN-NOET, 201Tl plasma activity was mostly unbound to plasma proteins.

Conclusion

99mTcN-NOET and 201Tl delineated the non-viable area in chronic non-reperfused and reperfused myocardial infarction. The significantly decreased 201Tl defect in reperfused infarction was likely due to partial diffusion of the tracer from the plasma into the oedema present in the infarcted area. Deposited perfusion tracers might be better suited than diffusible agents for the assessment of regional flow following reperfusion of myocardial infarction.

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Acknowledgements

All experiments were approved by the Animal Care and Use Committee of the Defense Research Center, Grenoble, France and they were performed by an authorised individual (A. Broisat, authorisation # 38 04 37). Financial support was provided by the National Institute for Health and Medical Research (INSERM) and the French Ministry of National Education and Research.

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Authors and Affiliations

  1. INSERM, U340 Radiopharmaceutiques Biocliniques; Université de Grenoble, 38700, La Tronche, France

    L. M. Riou, A. Broisat, G. Vanzetto, D. Fagret & C. Ghezzi

  2. Plateforme ANIMAGE, CERMEP, Lyon, France

    C. Lartizien & M. Janier

  3. Laboratoire NVMC, Faculté de Médecine de Grenoble, Grenoble, France

    M. C. Toufektsian

  4. Biospace Mesures, Paris, France

    S. Maitrejean

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  1. L. M. Riou
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  2. A. Broisat
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  9. C. Ghezzi
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Correspondence to L. M. Riou.

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Riou, L.M., Broisat, A., Lartizien, C. et al. Assessment of non-reperfused and reperfused myocardial infarction using diffusible or deposited radiolabelled perfusion imaging agents. Eur J Nucl Med Mol Imaging 34, 330–337 (2007). https://doi.org/10.1007/s00259-006-0230-3

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  • DOI: https://doi.org/10.1007/s00259-006-0230-3

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