Related Experiment Video

Updated: Aug 15, 2026

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
08:13

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography

Published on: February 16, 2016

Dual-isotope myocardial SPECT in patients with redefined myocardial infarction

Masato Fukushima1, Yoshihiko Seino, Shin-ichiro Kumita

  • 1First Department of Internal Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, 113-8603 Tokyo, Japan.

International Journal of Cardiology
|September 20, 2005
PubMed

Insights

New myocardial infarction (MI) criteria reclassified unstable angina (UA) patients. Dual-isotope SPECT showed perfusion and metabolic defects in redefined MI patients, but detection of minor infarcts was limited.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Diagnostic Imaging

Background:

  • Myocardial infarction (MI) redefinition by ESC/ACC criteria includes unstable angina (UA) patients with elevated troponin T but normal creatine kinase (CK).
  • This study retrospectively evaluated patients previously diagnosed with UA based on these new MI criteria.

Purpose of the Study:

  • To reclassify UA patients into redefined MI and UA groups using ESC/ACC criteria.
  • To assess the utility of dual-isotope myocardial perfusion and metabolism single-photon emission computed tomography (SPECT) in differentiating these groups.

Main Methods:

  • 146 UA patients with low CK levels underwent dual-isotope SPECT using Thallium-201 (Tl) and (123)I-BMIPP.
  • Patients were reclassified based on troponin T levels (>0.10 ng/ml or positive rapid assay).
  • SPECT findings (perfusion and metabolism) were analyzed qualitatively and quantitatively by blinded observers.

Main Results:

  • 32% of patients (47/146) were redefined as MI, and 68% (99/146) as UA.
  • Redefined MI patients showed significantly higher white blood cell count, C-reactive protein, CK, and CK-MB on admission.
  • Perfusion defects (Tl) and metabolic abnormalities (BMIPP) were significantly more prevalent in the redefined MI group (36% vs 4% and 64% vs 23%, respectively).
  • Semi-quantitative analysis revealed higher Tl and BMIPP scores in redefined MI patients.

Conclusions:

  • Redefined MI patients frequently exhibit more extensive perfusion and metabolic abnormalities.
  • Tl/BMIPP dual-isotope SPECT has limited sensitivity for detecting minor myocardial infarcts classified under the redefined criteria.
  • More sensitive stratification methods combined with troponin T assessment are needed for improved detection of minor infarcts.
Abstract

More Related Videos

A Microscopic 2,3,5-Triphenyltetrazolium Chloride Assay for Accurate and Reliable Analysis of Myocardial Injury11:17

A Microscopic 2,3,5-Triphenyltetrazolium Chloride Assay for Accurate and Reliable Analysis of Myocardial Injury

Published on: November 28, 2025

MRI and PET in Mouse Models of Myocardial Infarction10:46

MRI and PET in Mouse Models of Myocardial Infarction

Published on: December 19, 2013

Related Concept Videos

Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Myocarditis II: Clinical Features and Diagnostic Tests01:27

Myocarditis II: Clinical Features and Diagnostic Tests

Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
Imaging Studies for Cardiovascular System V: CT01:28

Imaging Studies for Cardiovascular System V: CT

Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
Imaging Studies II: Positron Emission Tomography and Scintigraphy01:25

Imaging Studies II: Positron Emission Tomography and Scintigraphy

Positron Emission Tomography (PET) is a medical imaging technique that provides crucial insights into the body's physiological functions at a molecular level. It is an indispensable resource for diagnosing, staging, and monitoring various illnesses, notably cancer, neurological disorders, and cardiovascular conditions.
Fundamental Principles of PET
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...