{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,29]],"date-time":"2023-10-29T06:40:15Z","timestamp":1698561615664},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2009,2,3]],"date-time":"2009-02-03T00:00:00Z","timestamp":1233619200000},"content-version":"vor","delay-in-days":3900,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[1998,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Background<\/jats:italic>: Thallium\u2010201 (<jats:sup>201<\/jats:sup>Tl) reinjection after conventional redistribution imaging is a standard procedure, resulting in enhanced <jats:sup>201<\/jats:sup> Tl redistribution which is compatible with viable myocardium. Although this method significantly improves identification of viable myocardium, it increases the investigation time by approximately 1 h. Thus, this technique is suboptimal from the standpoint of patient convenience, since its routine performance may be impractical in a high\u2010volume nuclear medicine laboratory.<\/jats:p><jats:p><jats:italic>Hypothesis<\/jats:italic>: This study was undertaken to evaluate the efficacy of an early <jats:sup>201<\/jats:sup>Tl reinjection and imaging protocol in combination with sublingual nitroglycerin, to detect myocardial ischemia and\/or viability, and to reduce the need for conventional (4 h) redistribution imaging.<\/jats:p><jats:p><jats:italic>Materials and Methods<\/jats:italic>: In this study, 62 consecutive coronary patients, referred for the detection of possible myocardial ischemia and\/or viability, were involved (mean age 55 years, range 41\u201070). Of those, 50 had previous angina attacks, with 42 having a history of previous myocardial infarction; 10 patients had coronary artery bypass grafting; and the remaining 2 had atypical chest pain. Immediately after the completion of the initial postexer\u2010cise imaging, 0.3 mg sublingual nitroglycerin followed by the reinjection of 1 m Ci of <jats:sup>201<\/jats:sup>Tl were administered, and two further sets of images were acquired 1 h and 4h later.<\/jats:p><jats:p><jats:italic>Results<\/jats:italic>: In each set of i mages, a total of496 segments were analyzed. On postexercise imaging, 305 (61%) segments demonstrated defects of which 198 (65%) showed enhanced thallium uptake, 97 (32%) did not change, and 10(3%) showed reverse redistribution on 1 h reinjection imaging (IRI). Of the 97 persistent defects, only 17 (6%) showed fill\u2010in of <jats:sup>201<\/jats:sup> Tl on 4 h redistribution imaging (CRI), while 12 (4%) segments showed reverse redistribution. On the other hand, after analyzing the 62 patients of the 1 h IRI, 17 (27%) remained unchanged while in only 1 patient (6%) of 17 the diagnosis changed from myocardial necrosis to ischemia after analysis ofthe 4h CRI.<\/jats:p><jats:p>Conclusion: These results indicate that early postexercise reinjection of <jats:sup>201<\/jats:sup>Tl in combination with sublingual nitroglycerin followed by l h image acquisition may prove useful for a comprehensive and convenient assessment of myocardial ischemia and\/or viability.<\/jats:p>","DOI":"10.1002\/clc.4960210610","type":"journal-article","created":{"date-parts":[[2009,2,4]],"date-time":"2009-02-04T01:37:54Z","timestamp":1233711474000},"page":"419-426","source":"Crossref","is-referenced-by-count":0,"title":["Early postexercise thallium\u2010201 reinjection after sublingual nitroglycerin augmentation: Effects on detection of myocardial ischemia and\/or 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