Basic properties of myocardial perfusion agents
- Thomas A Holly, MD
Thomas A Holly, MD
- Professor of Medicine and Radiology
- Feinberg School of Medicine, Northwestern University
- Preeti Kansal, MD
Preeti Kansal, MD
- Assistant Professor of Medicine
- Feinberg School of Medicine, Northwestern University
Radionuclide myocardial perfusion imaging (MPI) involves the visualization of a radiopharmaceutical that is distributed throughout the myocardium in proportion to coronary blood flow, thereby permitting the determination of relative blood flow in various regions of the heart. Regional coronary blood flow (delivery) determines the amount of tracer activity within a specific area; close correlation between flow and activity has been demonstrated with the currently available radiopharmaceuticals over a physiologic range of coronary blood flow.
Perfusion imaging is dependent upon the physical properties of the radiolabeled tracer, its delivery, and its extraction and retention by the myocyte. Both cell membrane integrity and energy utilization are necessary for intracellular extraction and retention of tracer. Thus, retained tracer activity is synonymous with myocyte viability. Revascularization of such segments can lead to improvement in left ventricular function. (See "Evaluation of hibernating myocardium" and "Diagnosis and management of ischemic cardiomyopathy".)
The ideal perfusion agent would have the following characteristics:
●High first pass myocardial extraction
●Linear relationship between uptake and flow
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