Molecular imaging identifies regions with microthromboemboli during primary angioplasty in acute coronary thrombosis

Tadamichi Sakuma, Jiri Sklenar, Howard Leong-Poi, Norman C. Goodman, David K. Glover, Sanjiv Kaul

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Microthromboemboli (MTE) may contribute to the no-reflow phenomenon in acute myocardial infarction (AMI) either spontaneously or after primary percutaneous transluminal coronary angioplasty (PTCA). We hypothesized that myocardial MTE in acute coronary syndromes can be identified on imaging by in vivo 99mTc labeling of the coronary thrombus with a compound that binds to the glycoprotein IIb/IIIa present on activated platelets (DMP-444). Methods: Fifteen dogs underwent left anterior descending coronary artery (LAD) injury in to produce thrombus, whereas 5 control dogs had LAD ligation. Before recanalization, the risk area (RA) and myocardial blood flow (MBF) were measured, and in vivo thrombus labeling was performed using 99mTc- labeled DMP-444. Nine of the 15 LAD injury dogs had occlusive thrombus on angiography and underwent PTCA. MBF measurements were repeated 30 and 60 min after recanalization, and 99mTc autoradiography (hot spot imaging) was performed ex vivo to determine the extent and magnitude of MTE. Results: The ratio of hot spot size to RA size was higher in the 9 LAD injury dogs with thrombus compared with the 6 dogs with no thrombus (90% ± 22% vs. 42% ± 16%; P = 0.005). In control dogs, this ratio was significantly lower (29% ± 11%; P = 0.05). 99mTc activity within the RA was higher in 8 of the 15 coronary injury dogs with AMI compared with those without AMI (1.8 ± 0.48 vs. 1.24 ± 0.22; P = 0.02). Conclusion: MTE can be detected and quantified after primary PTCA. The infarct size is proportional to the magnitude and extent of MTE, indicating that MTE may contribute to the AMI. Thus, in vivo thrombus labeling during reperfusion may provide important information in patients with AMI that may lead to better adjuvant therapy during PTCA.

Original languageEnglish (US)
Pages (from-to)1194-1200
Number of pages7
JournalJournal of Nuclear Medicine
Volume45
Issue number7
StatePublished - Jul 1 2004
Externally publishedYes

Fingerprint

Coronary Thrombosis
Molecular Imaging
Angioplasty
Thrombosis
Dogs
Coronary Balloon Angioplasty
Myocardial Infarction
Wounds and Injuries
No-Reflow Phenomenon
Platelet Glycoprotein GPIIb-IIIa Complex
Acute Coronary Syndrome
Autoradiography
Reperfusion
Ligation
Coronary Vessels
Angiography
Blood Platelets

Keywords

  • Autoradiography
  • Glycoprotein IIb/IIIa receptor
  • Myocardial blood flow

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Molecular imaging identifies regions with microthromboemboli during primary angioplasty in acute coronary thrombosis. / Sakuma, Tadamichi; Sklenar, Jiri; Leong-Poi, Howard; Goodman, Norman C.; Glover, David K.; Kaul, Sanjiv.

In: Journal of Nuclear Medicine, Vol. 45, No. 7, 01.07.2004, p. 1194-1200.

Research output: Contribution to journalArticle

Sakuma, T, Sklenar, J, Leong-Poi, H, Goodman, NC, Glover, DK & Kaul, S 2004, 'Molecular imaging identifies regions with microthromboemboli during primary angioplasty in acute coronary thrombosis', Journal of Nuclear Medicine, vol. 45, no. 7, pp. 1194-1200.
Sakuma, Tadamichi ; Sklenar, Jiri ; Leong-Poi, Howard ; Goodman, Norman C. ; Glover, David K. ; Kaul, Sanjiv. / Molecular imaging identifies regions with microthromboemboli during primary angioplasty in acute coronary thrombosis. In: Journal of Nuclear Medicine. 2004 ; Vol. 45, No. 7. pp. 1194-1200.
@article{d71c71e8087240949684b1284b519d30,
title = "Molecular imaging identifies regions with microthromboemboli during primary angioplasty in acute coronary thrombosis",
abstract = "Microthromboemboli (MTE) may contribute to the no-reflow phenomenon in acute myocardial infarction (AMI) either spontaneously or after primary percutaneous transluminal coronary angioplasty (PTCA). We hypothesized that myocardial MTE in acute coronary syndromes can be identified on imaging by in vivo 99mTc labeling of the coronary thrombus with a compound that binds to the glycoprotein IIb/IIIa present on activated platelets (DMP-444). Methods: Fifteen dogs underwent left anterior descending coronary artery (LAD) injury in to produce thrombus, whereas 5 control dogs had LAD ligation. Before recanalization, the risk area (RA) and myocardial blood flow (MBF) were measured, and in vivo thrombus labeling was performed using 99mTc- labeled DMP-444. Nine of the 15 LAD injury dogs had occlusive thrombus on angiography and underwent PTCA. MBF measurements were repeated 30 and 60 min after recanalization, and 99mTc autoradiography (hot spot imaging) was performed ex vivo to determine the extent and magnitude of MTE. Results: The ratio of hot spot size to RA size was higher in the 9 LAD injury dogs with thrombus compared with the 6 dogs with no thrombus (90{\%} ± 22{\%} vs. 42{\%} ± 16{\%}; P = 0.005). In control dogs, this ratio was significantly lower (29{\%} ± 11{\%}; P = 0.05). 99mTc activity within the RA was higher in 8 of the 15 coronary injury dogs with AMI compared with those without AMI (1.8 ± 0.48 vs. 1.24 ± 0.22; P = 0.02). Conclusion: MTE can be detected and quantified after primary PTCA. The infarct size is proportional to the magnitude and extent of MTE, indicating that MTE may contribute to the AMI. Thus, in vivo thrombus labeling during reperfusion may provide important information in patients with AMI that may lead to better adjuvant therapy during PTCA.",
keywords = "Autoradiography, Glycoprotein IIb/IIIa receptor, Myocardial blood flow",
author = "Tadamichi Sakuma and Jiri Sklenar and Howard Leong-Poi and Goodman, {Norman C.} and Glover, {David K.} and Sanjiv Kaul",
year = "2004",
month = "7",
day = "1",
language = "English (US)",
volume = "45",
pages = "1194--1200",
journal = "Journal of Nuclear Medicine",
issn = "0161-5505",
publisher = "Society of Nuclear Medicine Inc.",
number = "7",

}

TY - JOUR

T1 - Molecular imaging identifies regions with microthromboemboli during primary angioplasty in acute coronary thrombosis

AU - Sakuma, Tadamichi

AU - Sklenar, Jiri

AU - Leong-Poi, Howard

AU - Goodman, Norman C.

AU - Glover, David K.

AU - Kaul, Sanjiv

PY - 2004/7/1

Y1 - 2004/7/1

N2 - Microthromboemboli (MTE) may contribute to the no-reflow phenomenon in acute myocardial infarction (AMI) either spontaneously or after primary percutaneous transluminal coronary angioplasty (PTCA). We hypothesized that myocardial MTE in acute coronary syndromes can be identified on imaging by in vivo 99mTc labeling of the coronary thrombus with a compound that binds to the glycoprotein IIb/IIIa present on activated platelets (DMP-444). Methods: Fifteen dogs underwent left anterior descending coronary artery (LAD) injury in to produce thrombus, whereas 5 control dogs had LAD ligation. Before recanalization, the risk area (RA) and myocardial blood flow (MBF) were measured, and in vivo thrombus labeling was performed using 99mTc- labeled DMP-444. Nine of the 15 LAD injury dogs had occlusive thrombus on angiography and underwent PTCA. MBF measurements were repeated 30 and 60 min after recanalization, and 99mTc autoradiography (hot spot imaging) was performed ex vivo to determine the extent and magnitude of MTE. Results: The ratio of hot spot size to RA size was higher in the 9 LAD injury dogs with thrombus compared with the 6 dogs with no thrombus (90% ± 22% vs. 42% ± 16%; P = 0.005). In control dogs, this ratio was significantly lower (29% ± 11%; P = 0.05). 99mTc activity within the RA was higher in 8 of the 15 coronary injury dogs with AMI compared with those without AMI (1.8 ± 0.48 vs. 1.24 ± 0.22; P = 0.02). Conclusion: MTE can be detected and quantified after primary PTCA. The infarct size is proportional to the magnitude and extent of MTE, indicating that MTE may contribute to the AMI. Thus, in vivo thrombus labeling during reperfusion may provide important information in patients with AMI that may lead to better adjuvant therapy during PTCA.

AB - Microthromboemboli (MTE) may contribute to the no-reflow phenomenon in acute myocardial infarction (AMI) either spontaneously or after primary percutaneous transluminal coronary angioplasty (PTCA). We hypothesized that myocardial MTE in acute coronary syndromes can be identified on imaging by in vivo 99mTc labeling of the coronary thrombus with a compound that binds to the glycoprotein IIb/IIIa present on activated platelets (DMP-444). Methods: Fifteen dogs underwent left anterior descending coronary artery (LAD) injury in to produce thrombus, whereas 5 control dogs had LAD ligation. Before recanalization, the risk area (RA) and myocardial blood flow (MBF) were measured, and in vivo thrombus labeling was performed using 99mTc- labeled DMP-444. Nine of the 15 LAD injury dogs had occlusive thrombus on angiography and underwent PTCA. MBF measurements were repeated 30 and 60 min after recanalization, and 99mTc autoradiography (hot spot imaging) was performed ex vivo to determine the extent and magnitude of MTE. Results: The ratio of hot spot size to RA size was higher in the 9 LAD injury dogs with thrombus compared with the 6 dogs with no thrombus (90% ± 22% vs. 42% ± 16%; P = 0.005). In control dogs, this ratio was significantly lower (29% ± 11%; P = 0.05). 99mTc activity within the RA was higher in 8 of the 15 coronary injury dogs with AMI compared with those without AMI (1.8 ± 0.48 vs. 1.24 ± 0.22; P = 0.02). Conclusion: MTE can be detected and quantified after primary PTCA. The infarct size is proportional to the magnitude and extent of MTE, indicating that MTE may contribute to the AMI. Thus, in vivo thrombus labeling during reperfusion may provide important information in patients with AMI that may lead to better adjuvant therapy during PTCA.

KW - Autoradiography

KW - Glycoprotein IIb/IIIa receptor

KW - Myocardial blood flow

UR - http://www.scopus.com/inward/record.url?scp=4043181978&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=4043181978&partnerID=8YFLogxK

M3 - Article

C2 - 15235066

AN - SCOPUS:4043181978

VL - 45

SP - 1194

EP - 1200

JO - Journal of Nuclear Medicine

JF - Journal of Nuclear Medicine

SN - 0161-5505

IS - 7

ER -