PMID- 9768709
OWN - NLM
STAT- MEDLINE
DCOM- 19981020
LR  - 20190708
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 32
IP  - 4
DP  - 1998 Oct
TI  - Assessment of "microvascular no-reflow phenomenon" using technetium-99m 
      macroaggregated albumin scintigraphy in patients with acute myocardial 
      infarction.
PG  - 898-903
AB  - OBJECTIVES: The aim of this study was the scintigraphic evaluation of clinical 
      no-reflow phenomenon. BACKGROUND: In patients with acute myocardial infarction, 
      the relationship of the severity of reduction of microvascular reflow to the 
      ischemia time or to the secondary extension of myocardial necrosis is poorly 
      understood, and we accordingly conducted a scintigraphic evaluation of clinical 
      no-reflow phenomenon. METHODS: The group studied consisted of 25 consecutive 
      patients with their first acute myocardial infarction. After recanalization, each 
      patient received intracoronary injections of technetium-99m macroaggregated 
      albumin (MAA). RESULTS: Eight patients (32%) had absent tracer uptake 
      (scintigraphic no-reflow phenomenon). Fourteen patients showed absent or 
      moderately reduced MAA uptake (group 1) and 11 showed slightly reduced or normal 
      uptake (group 2). The time to recanalization was significantly longer in group 1 
      than in group 2 (290.4+/-130.6 min vs. 1773+/-93.5 min; p=0.0238). In chronic 
      phase, the thallium-201 (TI-201) defect score index was significantly larger (p < 
      0.01) and regional ejection fraction was significantly lower (p < 0.01) in group 
      1 compared with corresponding values in group 2. No significant deterioration 
      from acute phase to chronic phase in either TI-201 defect score index or regional 
      ejection fraction was found in either group (two-way repeated measures analysis 
      of variance). CONCLUSIONS: These findings suggest that scintigraphic noreflow 
      phenomenon occurs in a subgroup of patients without angiographic no-reflow 
      phenomenon, that the myocardial damage depends on the severity of microvascular 
      damage and that prolonged ischemia time may increase the likelihood of 
      "microvascular no-reflow phenomenon."
FAU - Kondo, M
AU  - Kondo M
AD  - Division of Cardiology, Shimada Municipal Hospital, Shizuoka, Japan. 
      kondom@gb3.so-net.or.jp
FAU - Nakano, A
AU  - Nakano A
FAU - Saito, D
AU  - Saito D
FAU - Shimono, Y
AU  - Shimono Y
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 0 (Radiopharmaceuticals)
RN  - 0 (Technetium Tc 99m Aggregated Albumin)
RN  - 0 (Thallium Radioisotopes)
SB  - IM
MH  - Aged
MH  - Angioplasty, Balloon, Coronary
MH  - Coronary Angiography
MH  - *Coronary Circulation
MH  - Female
MH  - Humans
MH  - Male
MH  - Microcirculation
MH  - Middle Aged
MH  - Myocardial Infarction/diagnostic imaging/*physiopathology/therapy
MH  - Myocardial Reperfusion
MH  - *Radiopharmaceuticals
MH  - *Technetium Tc 99m Aggregated Albumin
MH  - Thallium Radioisotopes
MH  - Tomography, Emission-Computed, Single-Photon
EDAT- 1998/10/13 00:00
MHDA- 1998/10/13 00:01
CRDT- 1998/10/13 00:00
PHST- 1998/10/13 00:00 [pubmed]
PHST- 1998/10/13 00:01 [medline]
PHST- 1998/10/13 00:00 [entrez]
AID - S0735-1097(98)00435-5 [pii]
AID - 10.1016/s0735-1097(98)00435-5 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 1998 Oct;32(4):898-903. doi: 10.1016/s0735-1097(98)00435-5.