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Myocardial Damage Delineated by Indium-111 Antimyosin Fab and Technetium-99m Pyrophosphate

Cardiac Unit and Departments of Radiology and Pathology, Massachusetts General Hospital, Boston, Massachusetts

Correspondence: For reprints contact: Ban An Khaw, PhD, Cardiac Unit, Jackson 13, Massachusetts General Hospital, Boston, Massachusetts 02114.

ABSTRACT

Technetium-99m-labeled pyrophosphate and radiolabeled antimyosin antibodies are two infarct localizing agents with apparently different kinetics of localization. To determine whether these agents localize in a similar fashion in early acute myocardial necrosis, we studied the simultaneous distribution of ¹¹¹In-labeled antimyosin and ^99mTc-labeled pyrophosphate in dogs after intracoronary (i.c.)(n = 9) or intravenous (i.v.)(n = 9) administration of a mixture of these two agents in a reperfused infarct model. The mean infarct size (± s.d.) delineated by pyrophosphate [20.2 ± 14.1 (i.v.), 29.8 ± 12.3 (i.c.)] was larger than that by antimyosin [14.2 ± 11.3 (i.v.)(p = 0.05), 20.0 ± 11.8 (i.c.)(p = 0.05)] which was larger than that by triphenyl tetrazolium chloride [13.9 ± 8.0 (i.v.)(p = 0.05), 15.3 ± 6.5 (i.c.)(p = 0.05)]. This overestimation persisted whether the radiopharmaceuticals were administered by intracoronary or intravenous injections, although the latter with antimyosin was only slightly larger (TTC:AM = 13.9:14.2)(p = n.s.). There was a good correlation, however, between antimyosin and pyrophosphate delineated infarct sizes in dogs with intracoronary injection (y = 0.82x + 13.33, r = 0.79) or i.v. injection (y = 1.208x + 3.01, r = 0.97) of the mixture of the two agents. Since the images of the ¹¹¹In and ^99mTc activities were obtained consecutively by identical methods, the overestimation of infarct size by pyrophosphate cannot be due to differences in spatial resolution of the techniques used. The differences in the areas of myocardial damage delineated by pyrophosphate and antimyosin in our study most probably denote the area of viable but compromised myocardium.

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				M. Breuer, A. Schutz, M. Engelhardt, C. Hammer, B.M. Kemkes, and M. Breuer Scintigraphy and Immunohistology of Antimyosin-Fab During Graft Rejection Angiology, July 1, 1999; 50(7): 563 - 571. [Abstract] [PDF]