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Effect of coronary reperfusion on technetium-99m methoxyisobutylisonitrile uptake by viable and necrotic myocardium in the dog

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Abstract

Technetium-99m hexakis-2-methoxyisobutyl isonitrile (99mTc-MIBI) distribution is flow-dependent, permitting the imaging of coronary perfusion defects. However, the behaviour of this tracer in viable and necrotic tissues within the ischaemic area at risk is still being debated. In a clinically relevant canine model, dogs were submitted either to a 24-h permanent occlusion (group 1) of the left descending coronary artery (LAD) or to a 90-min LAD occlusion followed by 22.5 h reperfusion (group 2). 99mTc-MIBI and radiolabelled microspheres were injected 3 h before sacrifice. After delimiting the area at risk and the infarct by Evans blue perfusion and triphenyltetrazolium chloride staining, heart slices were imaged by scintigraphy and tissue radioactivity measured in a gamma-counter. In the necrotic area of both groups, the 99mTc-MIBI distribution was proportional to the myocardial blood flow, approximating a 1:1 ratio (identity line slope l, intercept 0) with highly significant correlation coefficients (group 1 r = 0.87, group 2 r = 0.86), whereas in the viable-ischaemic area of both groups, the data points are widespread above and below the identity line, indicating both over- and underestimations of blood flow in these tissue areas. These results were more pronounced following reperfusion as compared with permanent occlusion. Multiple linear regression analysis confirms differences (P < 0.001) in 99Tc-MIBI distributions between the viable-ischaemic and the necrotic zones. Delineation of the ischaemic area at risk was possible only with permanent occlusion. A hypoper-fused area was observed after reperfusion but differs from the anatomical infarcted area. These results indicate that the 99mTc-MIBI distribution is not significantly influenced by myocardial cell death, whereas the relationship of 99mTc-MIBI to blood flow in the remaining viable-ischaemic myocardium salvaged by reperfusion appears more deeply affected. Therefore, the influence of tissue viability on the 99mTc-MIBI distribution in the myocardium must be reconsidered in the light of these observations.

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Authors and Affiliations

  1. Laboratory of Experimental Pathology and Department of Nuclear Medicine, Montreal Heart Institute, 5000 Belanger Street East, H1T 1C8, Montreal, Quebec, Canada

    Yahye Merhi, Jean-Gilles Latour, André Arsenault & Guy Rousseau

  2. Department of Pathology, University of Montreal, Canada

    Jean-Gilles Latour

Authors
  1. Yahye Merhi
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  2. Jean-Gilles Latour
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  3. André Arsenault
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  4. Guy Rousseau
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Supported by grant IU-0027, Medical Research Council of Canada

Postdoctoral fellow of the Canadian Heart Foundation

Bursor from the Canadian Heart Foundation

Offprint requests to: J.-G. Latour

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Merhi, Y., Latour, JG., Arsenault, A. et al. Effect of coronary reperfusion on technetium-99m methoxyisobutylisonitrile uptake by viable and necrotic myocardium in the dog. Eur J Nucl Med 19, 503–510 (1992). https://doi.org/10.1007/BF00185856

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  • DOI: https://doi.org/10.1007/BF00185856

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