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Changes in first-pass interstitial kinetics of DTPA in myocardium submitted to low-flow ischemia
Fatiha Maskali1, Adey Ayalew, Pierre-Yves Marie
1Department of Nuclear Medicine, Unité mixte UHP-Inserm U684, and the Laboratory of Hematology and Physiology, Faculty of Pharmacy, University Henri Poincaré, Nancy, France. Fatiha.Maskali@medecine.uhp-nancy.fr
Objectives:
This study aimed to determine the changes during ischemia in the myocardial first-pass kinetics of DTPA, an extracellular tracer that is currently used for assessing myocardial perfusion with magnetic resonance imaging (Magnevist).
Materials And Methods:
Using an indicator-dilution technique, first-pass kinetics of DTPA were compared between normoxia (n=11) and low-flow ischemia (n=11) in isolated rabbit hearts perfused with red blood cell-enhanced perfusate.
Results:
There was no difference between ischemia and normoxia in the interstitial extraction and clearance rates of DTPA. Interstitial distribution volume of DTPA was, however, lower in ischemia than in normoxia (in percent of myocardial volume: 15+/-11% vs 25+/-11%, P=0.02) as a result of a relationship with coronary flow (P<0.001).
Conclusions:
During low-flow myocardial ischemia, DTPA kinetics are unchanged, except for the interstitial distribution volume that is decreased, presumably because of the shrinkage of extracellular fluid. These kinetic properties are favorable for detecting myocardial ischemia at rest with magnetic resonance imaging.
