Skip to main content
SpringerLink
Log in

201Tl-redistribution analysis in early and delayed myocordial scintigrams of patients with coronary heart disease (CHD)

  • Published:
European Journal of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Scans were performed on 8 healthy subjects and 25 with coronary heart disease proven by angiography and ventriculography including 6 with previous myocardial infarction at rest, exercise, and 1 and 2 h after exercise. Data were collected by a gamma camera interfaced to a data collection system. In healthy subjects 201Tl distribution was homogeneous at rest and after exercise, the count rate ranging between 100%—as set in the region of maximum—and 80% over other regions of myocardium. In 19 patients with coronary heart disease it was uniform only at rest; 6 patients with previous myocardial infarction had locally diminished 201Tl uptake even at rest. In patients with coronary heart disease without previous myocardial infarction, scans made immediately after exercise showed significant 201Tl hypofixation in region of minimum, the count rate of which was less than 80% of the count rate as determined over region of maximum, 201Tl uptake. Scans made 1 and 2 h after exercise had filling-in of 201Tl within the region of minimum the count rate of which returned to the normal range of at least 80% of the count rate measured over region of maximum uptake. This return to resting distribution was called 201Tl redistribution. Six patients with coronary heart disease and previous myocardial infarction had 201Tl defects larger after exercise than at rest, without redistribution being observed. Redistribution in late postexercise scans is a sign of reversible ischemia in coronary heart disease. Scans at rest may be omitted in coronary heart disease, because transient ischemia is undetectable, unless spontaneous angina occurs during scan procedure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ashburn, W.L., Schelbert, H.R., Peterson, K.L., Khullar, S.C., O'Rourke, R.: Experimental and clinical investigations in myocardial imaging. In: Nuklearmedizin, H.W. Pabst, G.Hör, and H.A.E. Schmidt, (eds.) p. 127–133. Stuttgart-New York: F.K. Schattauer 1975

    Google Scholar 

  2. Bofilias, I.: Kohärente optische Filterverfahren in der Nuklearmedizin. In: Nuklearmedizin. H.W. Pabst, G. Hör, H.A.E. Schmidt, (eds.) p. 664–669. Stuttgart-New York: F.K. Schattauer, 1975

    Google Scholar 

  3. Britten, J.S., Blank, M.: Thallium activation of the (Na+−K+)-activated ATPase of rabbit kidney. Biochim. Biophys. Acta. 159, 160–166 (1968)

    Google Scholar 

  4. Büll, U. Niendorf, H.P., Strauer, B.E., Hast, B.: Evaluation of myocardial function with the 201Thallium scintimetry in various disease of the heart. A correlative study based on 100 patients. Eur. J. Nucl. Med. 18, 1–12 (1976)

    Google Scholar 

  5. Cannon, P., Dell, R.B., Dwyer, E.M. Jr: Evaluation of myocardial perfusion rates in patients with coronary artery disease. J. Clin. Invest. 51, 978–994 (1972)

    Google Scholar 

  6. Felix, R., Wagner, J., Pensky, W., Thurn, P., Neumann, G., Hünermann, B., Schaede, A., Simon, H., Winkler, C.: Die Myokard-Szintigraphie mit Thallium-201 als nichtinvasive Methode. Grundlagen und Methodik. Dtsch. med. Wschr. 100, 2373–2377 (1975)

    Google Scholar 

  7. Gelbart, A., Doherty, P.W., McLaughlin, P.R., Harrison, D.C.: Na+, K+-ATPase and coronary blood flow as determinants of Thallium-201 uptake by ischemic myocardium (Abstr.). Circulation 53, 54, Supp II, 70 (1976)

    Google Scholar 

  8. Gerry, J., Becker, L., Flaherty, J., Weisfeldt, M.: Flow independence of Thallium redistribution (Abstr.-No. 238). Am. Heart Ass. 32nd Ann. Meeting, Dallas/Texas Nov. 13–15th (1978)

  9. Gould, K.L., Lipscomb, K., Hamilton, G.W.: Physiologic basis for assessing critical coronary stenosis. Amer. J. Cardiol. 33, 87–94 (1974)

    Google Scholar 

  10. Hamilton, G.W., Trobaugh, B., Ritchie, J.W., Gould, K.W.: Myocardial imaging at rest and during exercise. Herz (München) 2, 146–150 (1977)

    Google Scholar 

  11. Hamilton, G.W., Trobaugh, G.B., Ritchie, J.L., Williams, D.L., Weaver, W.D., Gould, K.L.: Myocardial imaging with intravenously injected Thallium-201 in patients with suspected coronary artery disease (Analysis of technique and correlation with electrocardiographic, coronary anatomic and ventriculographic findings). Am. J. Cardiol. 39, 347–354 (1977)

    Google Scholar 

  12. Hör, G., Lichte, H., Pabst, H.W., Luther, M.: 201Tl-Myokardszintigraphie bei Herzinfarkt. Nuc. Comp. (Darmstadt) 5, 77–81 (1974)

    Google Scholar 

  13. Hör, G., Sebening, H., Sauer, E., Lichte, H., Dressler, J., Lutilsky, L., Wagner-Manslau, C., Pabst, H.W.: Clinical experience with 201Tl-myocardial scintigraphy (redistribution analysis) and ECG-gated blood pool scan. Herz (München) 2, 215–216 (1977)

    Google Scholar 

  14. Lebowitz, E., Greene, M.D., Bradley-Moore, P.R., Atkins, H., Ansari, A.N., Richards, P., Belgrave, E.: 201Tl-for medical use (Abstr.). J. Nucl. Med. 14, 421 (1973)

    Google Scholar 

  15. Lebowitz, E., Greene, M.D., Fairchild, R., Bradley-Moore, P.R., Atkins, H.L., Ansari, A.N., Richards, P., Belgrave, E.: Thallium-201 for medical use. I. J. Nucl. Med. 16, 151–155 (1975)

    Google Scholar 

  16. Lenaers, A., Van Thiel, E., Block, P., Lebedelle, M.: Myocardial imaging with Thallium-201 after exercise: Comparison with coronary arteriography and exercise electrocardiography. Herz (München) 2, 151–155 (1977)

    Google Scholar 

  17. Levy, M.N., Imperial, E.S., Zieske, H. jr: Collateral blood flow to the myocardium as determined by the clearance of rubidium-86-chloride. Circ. Res. 9, 1035–1043 (1961)

    Google Scholar 

  18. Maseri, A.: Pathophysiologic studies of the pulmonary and coronary circulations in man. Am. J. Cardiol. 38, 751–760 (1976)

    Google Scholar 

  19. Maseri, A., Parodi, O., Severi, S., Pesola, A.: Transient transmural reduction of myocardial blood flow, demonstrated by Thallium-201 scintigraphy, as a cause of variant angina. Circulation 54, 280–288 (1976)

    Google Scholar 

  20. Mathey, D., Montz, R., Hanrath, P., Knop, J., Kupper, W., Schneider, C., Bleifeld, W.: Kurziristige regionale Myokardischämie und ihre Folgen bei Prinzmetal-Angina-pectoris. Dtsch. med. Wschr. 103, 969 (1978)

    Google Scholar 

  21. Moir, Th.W.: Measurement of coronary blood flow in dogs with normal and abnormal oxygenation and function. Circ. Res. 19, 695–699 (1966)

    Google Scholar 

  22. Myers, W.W., Honig, C.R.: Amount and distribution of 86Rb transported into myocardium from ventricular lumen. Am. J. Physiol. 211, 739–745 (1966)

    Google Scholar 

  23. Pabst, H.W., Hör, G., Lichte, H., Sebening, H., Kriegel, H.: Experience with 201Thallium in detection of myocardial infarction. Eur. J. Nucl. Med. 1, 19–25 (1976)

    Google Scholar 

  24. Pitt, B., Strauss, H.W.: Myocardial imaging in the noninvasive evaluation of patients with suspected ischemic heart disease. Am. J. Cardiol. 37, 797–806 (1976)

    Google Scholar 

  25. Pitt, B., Strauss, H.W.: Cardiovascular Nuclear Medicine. Semin. Nucl. Med. 7, 3–6 (1977)

    Google Scholar 

  26. Pohost, G.M., Beller, G.A., McKusick, K.A., Moore, R.H., Zir, L.M., Potsaid, M.S.: Thallium-201 redistribution following transient myocardial ischemia (Abstr.). J. Nucl. Med. 17, 535 (1976)

    Google Scholar 

  27. Pohost, G.M., Beller, G.A., Potsaid, M.S., Guiney, T.E., Zir, L.M.: Serial myocardial imaging after a single dose of Thallium-201: A method for detecting reversible ischemia (Abstr.). Circulation 53, 54, Supp II, 217 (1976)

    Google Scholar 

  28. Pohost, G.M., Zir, L.M., Moore, R.H., McKusick, K.A., Guiney, T.E., Beller, G.A.: Differentiation of transiently ischemic from infarcted myocardium by serial imaging after a single dose of Thallium-201. Circulation 55, 294–302 (1977)

    Google Scholar 

  29. Renkin, E.M.: Transport of potassium-42 from blood to tissue in isolated mammalian skeletal muscle. Am. J. Physiol. 197, 1205–1210 (1959)

    Google Scholar 

  30. Schelbert, H., Schuler, G., Ashburn, W., Covell, J.: Time course of redistribution of Tl-201 after transient ischemia (Abstr.). J. Nucl. Med. 18, 598 (1977)

    Google Scholar 

  31. Schmahl, W., Lichte, H., Hör, G., Erhardt, W., Kriegel, H.: Biological behavior of Thallium 201 in normal and infarcted myocardium (Abstr.). 7th Eur. Congr. of Cardiology, Abstr. Book I, p. 442, Amsterdam, Juni 20–25th (1976)

  32. Schwartz, J.S., Ponto, R.A., Forstrom, L., Carlyle, P.F., Cohn, J.N.: Early redistribution of Thallium-201 after temporary ischemia in the pig (Abstr.). Circulation 53, 54, Supp II, 220 (1976)

    Google Scholar 

  33. Sebening, H., Sauer, E., Hör, G., Dressler, J., Lutilsky, L., Wagner-Manskau, C., Ulm, K., Pabst, H.W., Blömer, H.: Die Serienmyokardszintigraphie zur Beurteilung der postischämischen 201-Thallium-Aufnahme im linksventrikulären Myokard. Z. Kardiol. 68, 1–9 (1979)

    Google Scholar 

  34. Smith, R.O., Markov, A.K., Lehan, P.H., Flowers, W.M., jr, Hellems, H.K.: Rapid serial scans (K-43) detect transient myocardial ischemia without stress (Abstr.). J. Nucl. Med. 18, 598 (1977)

    Google Scholar 

  35. Strauss, H.W., Harrison, K., Langan, J.K., Lebowitz, E., Pitt, B.: Thallium-201 for myocardial imaging—Relation of Thallium-201 to regional myocardial perfusion Circulation 51, 641–645 (1975)

    Google Scholar 

  36. Strauss, H.W., Pitt, B.: Thallium-201 as a myocardial imaging agent. Semin. Nucl. Med. 7, 49–58 (1977)

    Google Scholar 

  37. Wackers, E.J.T.H., v.d. Schoot, J.B., Sokole, E.B., Samson, G., v. Niftrik, G.J.C., Lie, K.I., Durrer, D., Wellens, H.J.J.: Noninvasive visualisation of acute myocardial infarction in man with Thallium-201. Brit. Heart. J. 37, 741–744 (1975)

    Google Scholar 

  38. Weich, H.F., Strauss, H.W., Pitt, B.: The extraction of Thallium-201 by the myocardium Circulation 56, 188–191 (1977)

    Google Scholar 

  39. Wolf, F., Krönert, E., Bachmann, K., Schebelle, K., Gopinathan, K., Regler, R.: Klinische Ergebnisse der invasiv-koronarographischen und metabolischen Myokardszintigraphie. In: Radioaktive Isotope in Klinik und Forschung, R. Höfer, (ed), p. 475–486, H. Egermann, 1976

  40. Zaret, B.L., Cohen, L.S.: Radionuclides and the patient with coronary artery disease. Am. J. Cardiol. 35, 112–115 (1975)

    Google Scholar 

  41. Zaret, B.L., Stenson, R.E., Martin, N.D., Strauss, H.W., Wells, H.P. jr, McGowan, R.L., Flamm, M.D.: Potassium-43-myocardial perfusion scanning for the noninvasive evaluation of patients with false positive exercise test. Circulation 48, 1234–1241 (1973)

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Nuklearmedizinische Klinik und Poliklinik der Technischen Universität München, Munich, Federal Republic of Germany

    G. Hör, H. Sebening, E. Sauer, J. Dressler, L. Lutilsky, C. Wagner-Manslau, I. Bofilias, I. Wolf & H. W. Pabst

  2. I. Medizinische Klinik der Technischen Universität München, Munich, Federal Republic of Germany

    G. Hör, H. Sebening, E. Sauer, J. Dressler, L. Lutilsky, C. Wagner-Manslau, I. Bofilias & I. Wolf

Authors
  1. G. Hör
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. Sebening
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. Sauer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Dressler
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. L. Lutilsky
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. C. Wagner-Manslau
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. I. Bofilias
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. I. Wolf
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. H. W. Pabst
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hör, G., Sebening, H., Sauer, E. et al. 201Tl-redistribution analysis in early and delayed myocordial scintigrams of patients with coronary heart disease (CHD). Eur J Nucl Med 4, 343–350 (1979). https://doi.org/10.1007/BF00263302

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00263302

Keywords

Search

Navigation