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Updated: May 8, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Scintigraphic evidence that the right ventricular myocardium tolerates ischaemia better than the left ventricular
Insights
Right ventricular infarction is common in acute myocardial infarction. Intracoronary thrombolysis effectively restored blood flow, showing reversible right ventricular defects, unlike left ventricular defects.
Area of Science:
- Cardiology
- Nuclear Medicine
- Myocardial Imaging
Background:
- Right ventricular infarction (RVI) is a frequent complication of inferior acute myocardial infarction (AMI).
- Assessing RVI and its response to treatment is crucial for patient outcomes.
- Intracoronary thrombolysis is a reperfusion strategy for AMI.
Purpose of the Study:
- To determine the incidence of right ventricular infarction in patients with right coronary artery occlusion.
- To evaluate the effect of intracoronary thrombolysis on ischemic right ventricular myocardium.
- To compare the reversibility of right and left ventricular myocardial ischemia.
Main Methods:
- Intracoronary thallium scintigraphy was performed in 18 patients with complete right coronary artery occlusion undergoing thrombolysis.
- Simultaneous thallium-201 and technetium-99m pyrophosphate scintigraphy was conducted in 15 patients.
- Scintigraphy was performed before and after intracoronary thrombolysis.
Main Results:
- All 18 patients showed right ventricular thallium defects before thrombolysis, with all demonstrating new thallium uptake post-thrombolysis.
- 17 of 18 patients had left ventricular defects pre-thrombolysis; only 10 showed new uptake post-thrombolysis.
- 14/15 patients had left ventricular pyrophosphate uptake post-thrombolysis, with diffuse right ventricular uptake in most.
Conclusions:
- Right ventricular thallium defects are prevalent in inferior AMI due to right coronary artery occlusion.
- Right ventricular defects visualized by thallium scintigraphy are reversible after thrombolysis.
- Right ventricular myocardium appears more resilient to ischemia than left ventricular myocardium.
Abstract:
To study the incidence of right ventricular infarction and the effect of intracoronary thrombolysis on the ischaemic right ventricular myocardium, we performed intracoronary myocardial thallium scintigraphy in 18 patients with complete occlusion of the right coronary artery who underwent intracoronary thrombolysis. In 15 of these patients, intracoronary thallium-201 and technetium-99 m pyrophosphate scintigrams were performed simultaneously. All 18 patients had a right ventricular thallium defect before thrombolysis, and all had new thallium uptake after thrombolysis. 17 out of 18 patients had a left ventricular thallium defect before thrombolysis, but only 10 of them showed new thallium uptake after thrombolysis. 14 out of 15 patients had a left ventricular technetium-99 m pyrophosphate spot after thrombolysis and some diffuse pyrophosphate accumulation in the area of the right ventricle. In one patient pyrophosphate accumulation was found only in the area of the right ventricle. Thus, right ventricular thallium defects were detected by intracoronary thallium scintigraphy in the majority of patients with inferior acute myocardial infarction due to right coronary artery occlusion. Right ventricular thallium defects were always reversible in contrast to left ventricular thallium defects in the same patients, suggesting that right ventricular myocardium tolerates ischaemia better than left ventricular myocardium.
