[Assessment of myocardial viability by exercise stress-redistribution myocardial scintigraphy with thallium-201: the usefulness of C-map].

Abstract

Standard exercise (Ex)-redistribution (RD) myocardial imaging with thallium-201 (201Tl) may not differentiate viable myocardium from necrosis. This study was intended to clarify whether 201Tl washout rate (WOR) abnormality after Ex can detect myocardial viability in the myocardium with perfusion defect using routine RD image. We performed Ex-RD (three hours after) myocardial tomography with 201Tl in 29 patients with coronary artery disease. From myocardial tomography, 201Tl distribution Bull's-eye maps (Ex and RD) and WOR Bull's-eye map were made. At RD image before PTCA, by referring to the original image, the activity of the myocardial region below 40% to 55% of the maximal 201Tl activity was considered as perfusion defect (RD-Map). Then we constructed a new image (C-Map) by adding the location of WOR abnormality (< or = 30%) to the RD-Map and each map was divided into 17 segments. If the defect-segment in the RD-Map corresponded to WOR abnormality, the segment in the C-Map was judged as viable (no defect). The C-Map and myocardial imaging after PTCA (Post-Map) were compared. In the RD-Map before PTCA, defect was found in 152 segments but in the C-Map they decreased to 59 segments, while defect was found in 62 segments in the Post-Map. In 23 patients the number of defect-segments in the C-Map decreased as compared with those in the RD-Map. And in 22 of them, the Post-Map showed the reduction of defect-segments in comparison with the RD-Map, but in one of them defect did not change.(ABSTRACT TRUNCATED AT 250 WORDS)