Related Experiment Video
Updated: Aug 23, 2026
Improvement of a Closed Chest Porcine Myocardial Infarction Model by Standardization of Tissue and Blood Sampling Procedures
Published on: March 12, 2018
[Reduction of myocardial infarction size after primary percutaneous coronary intervention]
Alf-Age R Pettersen1, Carl Müller, Bjørn Bendz
1Hjerte-Lungesenteret, Hjerte-Lungesenteret, Ullevål universitetssykehus, 0407 Oslo. alf-age.pettersen@ulleval.no
Insights
Primary percutaneous coronary intervention (PCI) significantly reduces myocardial infarction size. Technetium 99m-tetrofosmin SPECT imaging shows a 60% reduction in hypoperfusion index six weeks post-PCI for ST-elevation myocardial infarction patients.
Area of Science:
- Cardiology
- Nuclear Medicine
- Interventional Cardiology
Background:
- Timely reperfusion is critical for reducing myocardial infarction size and improving patient prognosis.
- Primary percutaneous coronary intervention (PCI) is increasingly used for acute myocardial infarction.
- Technetium 99m-tetrofosmin SPECT is effective for assessing myocardial risk and infarct size via hypoperfusion index (HPI).
Purpose of the Study:
- To evaluate the effectiveness of primary PCI in reducing final infarct size.
- To assess changes in myocardial perfusion and infarct size over time using Technetium 99m-tetrofosmin SPECT.
Main Methods:
- 20 patients with acute ST-elevation myocardial infarction underwent primary PCI within six hours of symptom onset.
- Myocardium at risk and final infarct size were quantified using Technetium 99m-tetrofosmin SPECT.
- Imaging was performed immediately before PCI, and at a few hours, one week, and six weeks after PCI.
Main Results:
- The hypoperfusion index (HPI) decreased from 31% before PCI to 12% at six weeks, a 60% relative reduction (p < 0.01).
- Anterior wall infarctions showed greater myocardium at risk initially (36%) compared to inferior wall infarctions (24%).
- Anterior wall infarctions exhibited a higher salvage index compared to inferior wall infarctions.
Conclusions:
- Primary PCI leads to a significant reduction in final infarct size in patients with acute ST-elevation myocardial infarction.
- Technetium 99m-tetrofosmin SPECT demonstrates the efficacy of primary PCI in myocardial salvage.
Background:
Achieving reperfusion as soon as possible is essential in order to reduce myocardial infarction size and thus improve prognosis. An increasing number of patients with myocardial infarction are treated with primary percutaneous coronary intervention (PCI). Technetium 99m-tetrofosmin myocardial perfusion tomography (SPECT) is a valid test for assessing myocardium at risk and final infarct size expressed by a hypoperfusion index (HPI) of the left ventricular mass.
Material And Methods:
20 patients with acute ST-elevation myocardial infarction were treated with primary percutaneous coronary intervention within six hours of onset of symptoms. Myocardium at risk and final infarct size were assessed by Technetium 99m-tetrofosmin immediately before and a few hours, one week and six weeks after.
Results:
The hypoperfusion index immediately before percutaneous coronary intervention was 31%, four to six hours after PCI 25%, one week later 16% and six weeks later 12%, i.e. a relative reduction of 60% (p < 0.01). Anterior wall infarctions had a higher level of myocardium at risk before primary PCI compared to inferior wall infarctions (36% vs. 24%), but anterior wall infarctions had a higher salvage index compared to inferior wall infarctions.
Interpretation:
This non-controlled study shows a marked reduction in final infarction size in patients with acute ST-elevation myocardial infarction treated with primary PCI.
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