Non-invasive assessment of residual viability in postmyocardial infarction patients - Role of nuclear techniques

Oberdan Parodi, Paolo Marzullo, Gianmario Sambuceti, Danilo Neglia, Alessia Gimelli, Assuero Giorgetti

Research output: Contribution to journalArticlepeer-review

Abstract

The failure of non-imaging techniques in identifying viable segments has favoured the clinical application of nuclear imaging. The main pathways that support radionuclide imaging are cell membrane integrity, persistence of intermediary metabolism and demonstration of a residual coronary reserve. Thallium-201 reinjection or rest protocols allow the identification of viable myocardium in most of patients with wall motion abnormalities and appear to be the most diffuse, low-cost and available method to detect viable myocardium. More complex approaches use positron emission tomography and matched flow/metabolic information. Flow/metabolic 'mismatch' usually identifies most of hypoperfused regions that show post-operative improvement of regional wall motion. The last promising approach is represented by the demonstration of a maintained regional coronary reserve in dyssynergic areas. Technetium-99m-microspheres (or Teboroxime in the future) can be successfully used for this purpose. The clinical application of radionuclides appears to be one of the principal imaging tools able to identify residual viability.

Original languageEnglish
Pages (from-to)19-29
Number of pages11
JournalThe International Journal of Cardiac Imaging
Volume9
Issue number1 Supplement
DOIs
Publication statusPublished - Mar 1993

Keywords

  • myocardial viability
  • positron emission tomography
  • radioisotopes

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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