The Hypoxia-avid Imaging Agent ～(99)Tc～m-HL91 In Distinguish Myocardial Infarction From Myocardial Ischemia

The prognosis of the coronary artery disease patient has close re-lationship with the left ventricular dysfunction and the surviving abnor-mal myocardium. The left ventricular dysfunction can be due to the unrevesible myocardial infarction or hibernating myocardium.The myocardial infarction tissue can' t be normalized by treat-ment, but the hibernating tissue can be normalized by the revascular-ization of the coronary artery, but Many kinds of method to detect the surviving myocardial tissue have their value, but they also have their shortage. The hypoxia - avid imaging agent is a positive agent. The hypoxia tissue and cell can accumulate it selectively.The hypoxia - avid imaging agent can prove the survival of the dysfunction tissue. So it can play an important role in detecting the is-chemic but surviving myocardial tissue rapidly and accurately. The ac-cumulation of (99)^Tc^m - HL91 is very high in the ischemic myocardial tissue. The accumulation of (99)^Tc^m - HL91 is significantly higher than that in the control tissue. The accumulation of (99)^Tc^m- HL91 is lower in liver than that in the myocardial tissue. Some researches indicate that in detecting the ischemic but surviving myocardial tissue the (99)^Tc^m-HL91 is better than F - FDG. But there is no clinical report a-buut (99)^Tc^m - HL91 now. ObjectiveBy examining the accumulation of (99)^Tc^m- HL91 in normal ische-mic and infarction myocardium, the purpose of this study is to re-search whether the (99)^Tc^m - HL91 can be used to distinguish ischemic myocardium from infarction myocardium. Materials and Methods30 patients, 17 men 13 women with mean age 54 years old are re-searched. The patients are divided into acute myocardial infarction group (25 patients 15 men 10 women with mean age 55 years old and<6 weeks infarct history) and old myocardial infarction group(5 pa-tient 2 men 3 women with mean age 49 years old and > 6 months in-farct history)every patient have image with (99)^Tc^m - methoxy - isobutyl - isoni-trile ((99)^Tc^m - MIBI) intervented and unintervented by nitroglycer in normally, one day is between the two checks. The first is the imaging intervented by nitroglycer, the second is the rest imaging, the nitroglyc-er in (0. 5 mg) is sublingually administered before the injection of(99)^Tc^m - MIBI. The dose is 555 MBq the nitroglycer in - intervented and the rest imaging is performed using single photon emission compu-ted tomography to make raw data acquisition and established the polar map. Every polar map is divided into nine areas. The radial count is indicated by the ratio to the radial count of maximal area, the accumu-lation of (99)^Tc^m - MIBI is indicated by it.The attainment of (99)^Tc^m - HL91 polar map:The (99)^Tc^m - HL91 is injected after the rest (99)^Tc^m - MIBI imaging. The dose is 555 MBq. It is twenty minutes before making raw data acquisition and established the polar map. the polar map must be minused by the re8t(99)^Tc^m -MIBI polar map to get(99)^Tc^m - HL91 polar map. The others are done in terms of the former, the accumulation is indicated by the ratio to the radial count of (99)^Tc^m - HL91 in the area that have the maximal radial count of (99)^Tc^m-HL91.The areas are divided into three groups: normal, ischemic and in-farction. In the rest (99)^Tc^m - MIBI imaging the accumulation of (99)^Tc^m -MIBI is higher than 70% in normal area, and lower than 70% in ab-normal. In the (99)^Tc^m - MIBI imaging intervented by nitroglycer The area where the increased accumulation is higher than 20% is ischemic myocardium, or it is the infarction myocardium, The difference of the radial count of (99)^Tc^m - HI 91 in three groups must be tested (a =0. 05 two sided test) . Results1. there are 225 areas in the acute myocardial infarction 25 pa-tientt.111l areas are nornral. 114 areas, are abnormal. 66 areas are positive intervented by the nitroglycer (the increased accumulation of (99)^Tc^m - MIB 20% ) , in old myocardial infa...