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Location of myocardium at risk in patients with first-time ST-elevation infarction: comparison among single photon emission computed tomography, magnetic resonance imaging, and electrocardiography.

Ubachs, Joey LU ; Engblom, Henrik LU ; Hedström, Erik LU ; Selvester, Ronald H; Knippenberg, Stephanie A M; Wagner, Galen S; Gorgels, Anton P M and Arheden, Håkan LU (2009) In Journal of Electrocardiology 42. p.198-203
Abstract
BACKGROUND: The amount of myocardium at risk (MaR) during acute coronary occlusion and the duration of occlusion are important determinants of final infarct size. The main goal of early reperfusion therapy is to salvage ischemic myocardium, thereby preserving left ventricular function. The aims of the present study were to test the feasibility of developing polar plot representations of MaR, for perfusion single photon emission computed tomography (SPECT), regional wall thickening by magnetic resonance imaging (MRI), and distribution of ST-segment changes. A second aim was to test the hypothesis that these different modalities display similar localization of the MaR in patients with reperfused first-time myocardial infarction. METHODS:... (More)
BACKGROUND: The amount of myocardium at risk (MaR) during acute coronary occlusion and the duration of occlusion are important determinants of final infarct size. The main goal of early reperfusion therapy is to salvage ischemic myocardium, thereby preserving left ventricular function. The aims of the present study were to test the feasibility of developing polar plot representations of MaR, for perfusion single photon emission computed tomography (SPECT), regional wall thickening by magnetic resonance imaging (MRI), and distribution of ST-segment changes. A second aim was to test the hypothesis that these different modalities display similar localization of the MaR in patients with reperfused first-time myocardial infarction. METHODS: Eleven patients with first-time myocardial infarction with ST-elevation received (99m)Tc tetrofosmin before primary percutaneous coronary intervention, SPECT imaging within 3 hours, and cardiac MRI of the left ventricle within 24 hours. The results for SPECT, MRI, and electrocardiogram (ECG) were developed into polar plots, and two expert observers designated the culprit coronary artery as assessed by angiography. RESULTS: The perfusion SPECT, MRI wall thickening, and ST changes are presented in side-by-side polar plots. In total, the culprit artery, based on the location of the MaR, was correctly designated in 91%, 82%, and 91% of cases by SPECT, MRI, and ECG, respectively. CONCLUSIONS: Polar representation for localization of the MaR by SPECT perfusion, MRI wall thickening, and ECG ST-segment deviation is feasible. All 3 modalities have the potential to be used for indirect visual designation of the culprit artery in patients with first-time acute coronary occlusion. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Electrocardiology
volume
42
pages
198 - 203
publisher
Elsevier
external identifiers
  • wos:000264220000015
  • pmid:19100566
  • scopus:60349131444
ISSN
1532-8430
DOI
10.1016/j.jelectrocard.2008.11.003
language
English
LU publication?
yes
id
6e356cc0-5e6c-4506-a024-3f33502af4db (old id 1276024)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19100566?dopt=Abstract
date added to LUP
2009-01-09 12:49:44
date last changed
2017-01-15 04:23:42
@article{6e356cc0-5e6c-4506-a024-3f33502af4db,
  abstract     = {BACKGROUND: The amount of myocardium at risk (MaR) during acute coronary occlusion and the duration of occlusion are important determinants of final infarct size. The main goal of early reperfusion therapy is to salvage ischemic myocardium, thereby preserving left ventricular function. The aims of the present study were to test the feasibility of developing polar plot representations of MaR, for perfusion single photon emission computed tomography (SPECT), regional wall thickening by magnetic resonance imaging (MRI), and distribution of ST-segment changes. A second aim was to test the hypothesis that these different modalities display similar localization of the MaR in patients with reperfused first-time myocardial infarction. METHODS: Eleven patients with first-time myocardial infarction with ST-elevation received (99m)Tc tetrofosmin before primary percutaneous coronary intervention, SPECT imaging within 3 hours, and cardiac MRI of the left ventricle within 24 hours. The results for SPECT, MRI, and electrocardiogram (ECG) were developed into polar plots, and two expert observers designated the culprit coronary artery as assessed by angiography. RESULTS: The perfusion SPECT, MRI wall thickening, and ST changes are presented in side-by-side polar plots. In total, the culprit artery, based on the location of the MaR, was correctly designated in 91%, 82%, and 91% of cases by SPECT, MRI, and ECG, respectively. CONCLUSIONS: Polar representation for localization of the MaR by SPECT perfusion, MRI wall thickening, and ECG ST-segment deviation is feasible. All 3 modalities have the potential to be used for indirect visual designation of the culprit artery in patients with first-time acute coronary occlusion.},
  author       = {Ubachs, Joey and Engblom, Henrik and Hedström, Erik and Selvester, Ronald H and Knippenberg, Stephanie A M and Wagner, Galen S and Gorgels, Anton P M and Arheden, Håkan},
  issn         = {1532-8430},
  language     = {eng},
  pages        = {198--203},
  publisher    = {Elsevier},
  series       = {Journal of Electrocardiology},
  title        = {Location of myocardium at risk in patients with first-time ST-elevation infarction: comparison among single photon emission computed tomography, magnetic resonance imaging, and electrocardiography.},
  url          = {http://dx.doi.org/10.1016/j.jelectrocard.2008.11.003},
  volume       = {42},
  year         = {2009},
}