COMPARISON OF DIFFERENT NONINVASIVE METHODS OF INFARCT SIZING DURING EXPERIMENTAL MYOCARDIAL-INFARCTION

  • 1 January 1977
    • journal article
    • research article
    • Vol. 18  (6) , 517-523
Abstract
The accuracy of several noninvasive infarct-sizing techniques was evaluated in 12 awake, unsedated dogs with multivessel coronary obstructions and acute anterior myocardial infarcts. Estimations of infarct size by scintigraphy with 99mTc Sn pyrophosphate (Tc-PPi), serum creatine phosphokinase (CPK) release, peak serum myoglobin levels by radioimmunoassay and precordial ECG mapping were compared and correlated with histologic measurements of infarct size. The comparisons indicate that precordial ST segment mapping, serum CPK release measurements and peak serum CPK, peak serum myoglobin and Tc-PPi myocardial scintigraphy all provide approximate estimates of infarct size in this model. Precordial mapping is relatively insensitive in the identification of small anterior infarcts. Serial serum CPK release measurements when obtained for only 24 h after infarction tend to underestimate large anterior infarct size. Tc-PPi myocardial scintigrams may fail to recognize anterior infarcts less than 3 g in size and may overestimate the size of small predominantly subendocardial infarcts. The closest estimate of histologic infarct size in this model was provided by combining 2 of the noninvasive techniques (precordial mapping to identify sites with 2 or more millimeters of ST segment elevation and Tc-PPi myocardial scintigrams) rather than by relying exclusively on any one technique alone.