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Comparison of Coronary Angiographic Features and Oral Dipyridamole Thallium 201 Tomography

University of North Carolina Hospitals, Cardiac Catheterization Laboratory, Chapel Hill, North Carolina

G. Hunter Myers

University of North Carolina Hospitals, Cardiac Catheterization Laboratory, Chapel Hill, North Carolina

Mathew W. Rowe

University of North Carolina Hospitals, Cardiac Catheterization Laboratory, Chapel Hill, North Carolina

Gregory J. Dehmer

University of North Carolina Hospitals, Cardiac Catheterization Laboratory, Chapel Hill, North Carolina

Debra S. Robinson

University of North Carolina Hospitals, Cardiac Catheterization Laboratory, Chapel Hill, North Carolina

Coronary angiography and left ventriculography is commonly used to identify those patients with incomplete infarctions and therefore, a need for revascular ization. The authors compared coronary angiography and left ventriculography with thalliumm 201 tomography using oral dipyridamole to identify patients with potential ischemia in the infarct zone indicating viable tissue. Forty-five patients (37 men, 8 women) with acute myocardial infarctions (29 anterior, 16 inferior) who received intravenous thrombolytic therapy were studied. On the basis of the left ventriculograms, only 16 patients were judged to have residual function in the infarct zone . Six of these patients had no thallium redistribution in the infarct zone, indicating lack of residual ischemia. Of the 29 patients with no residual function in the infarct zone, 18 had redistribution in the infarct zone, suggesting residual ischemic myocardium and thus viable tissue . Among the 32 patients with open infarct vessels, 15 had no redistribution in the infarct zone, but of the remaining 13 patients with occluded infarct vessels, 9 had redistribution in the infarct zone indicating residual ischemia and thus viable tissue . The authors' data suggest that neither wall motion analysis by left ventriculography nor the an giographic status of the infarct vessel identifies those patients with residual ischemia as evidenced by thallium tomography using oral dipyridamole.

Angiology, Vol. 42, No. 2, 99-105 (1991)
DOI: 10.1177/000331979104200203


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