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The Role of Early Measurement of Nitrogen-13 Ammonia Uptake for Predicting Contractile Recovery after Acute Myocardial Infarction
LANCELLOTTI, Patrizio; Melon, P. G.; de Landsheere, C. M. et al.
1998In International Journal of Cardiac Imaging, 14 (4), p. 261-7, discussion 269-70
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Abstract :
[en] Previous studies have shown that the maintenance of cell membrane integrity and metabolism requires the persistence of residual myocardial blood flow. The purpose of this study was to assess the role of N-13 ammonia positron emission tomographic (PET) imaging performed early after an acute myocardial infarction for predicting functional recovery. Seventeen patients with an acute myocardial infarction were included in the study. Thirteen received thrombolytic therapy, 2 underwent immediate angioplasty of the infarct-related artery and 2 were treated with heparin. N-13 ammonia imaging was performed 6 +/- 2 days after the acute event and was followed by elective angioplasty in 13 patients. Using a 16-segment polar map display, regional N-13 ammonia uptake was expressed as a percentage of maximal segmental uptake and classified as normal (> 63%), moderately reduced (63-50%) and severely reduced (< 50%) based on values of tracer uptake obtained from healthy subjects. By echocardiographic assessment of regional wall thickening within 96 hours and at 1 month after the infarct, we examined the relationship between blood flow and functional outcome of myocardial segments in the infarct-related area. Regional wall thickening was graded on a 4-point scale: normal (1), hypokinesia (2), akinesia (3) and dyskinesia (4). Of 77 dyssynergic segments at baseline echocardiographic study, 43 had normal flow, 15 moderately reduced flow and 19 severely reduced flow. Segments with N-13 ammonia uptake > or = 50% demonstrated a significant improvement in wall thickening score at follow-up (p < 0.001), whereas segments with N-13 ammonia uptake < 50% showed no improvement in wall thickening scores (p < 0.001). The proportion of segments improving contractility by at least 1 score was significantly higher in the group of segments with N-13 ammonia uptake > 63%. The predictive value for defining functional recovery with segmental N-13 ammonia uptake > 63% was 86%. The predictive value for absence of recovery (uptake < 50%) was 54%. In conclusion, our data showed that early after an acute myocardial infarction N-13 ammonia imaging provides information regarding functional outcome.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
LANCELLOTTI, Patrizio  ;  Centre Hospitalier Universitaire de Liège - CHU > Cardiologie
Melon, P. G.
de Landsheere, C. M.
Degueldre, Christian ;  Université de Liège - ULiège > Centre de recherches du cyclotron
Kulbertus, Henri ;  Université de Liège - ULiège > Relations académiques et scientifiques (Médecine)
PIERARD, Luc ;  Centre Hospitalier Universitaire de Liège - CHU > Cardiologie
Language :
English
Title :
The Role of Early Measurement of Nitrogen-13 Ammonia Uptake for Predicting Contractile Recovery after Acute Myocardial Infarction
Publication date :
August 1998
Journal title :
International Journal of Cardiac Imaging
ISSN :
0167-9899
Publisher :
Kluwer Academic Publishers, Netherlands
Volume :
14
Issue :
4
Pages :
261-7, discussion 269-70
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 26 June 2013

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