Detection and size estimation of acute myocardial infarction using 99Tc-glucoheptonate

Twenty-seven patients with suspected acute myocardial infarction were studied by precordial scanning after intravenous administration of 99mTc-gluchoheptonate 2-48 hr after the onset of chest pain. Fifteen of the patients had clinically documented acute myocardial infarctions. Twelve of these 15 (80%) had areas of distinctly increased tracer uptake in the region of the heart. The three infarctions not identified by scan had peak serum CPK values of less than 300. In seven patients without infarction, no distinct areas of increased tracer uptake were found in the region of the heart. Five patients could not be classified as to whether infarction had or had not occurred. Three had abnormal scans, the significance of which is uncertain. Infarct size was estimated from the area of increased 99mTc-glucoheptonate concentration on scan and compared to peak serum CPK values. A linear correlation with a correlation coefficient of 0.77 was found. Technetium-99-m-glucoheptonate scanning was useful for the identification and size estimation of moderate- to large-size transmural and nontransmural acute myocardial infaractions.