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Basic properties of myocardial perfusion agents

Thomas A Holly, MD
Preeti Kansal, MD
Section Editor
Warren J Manning, MD
Deputy Editor
Brian C Downey, MD, FACC


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 "Ischemic cardiomyopathy: Treatment and prognosis".)

The ideal perfusion agent would have the following characteristics:

High first pass myocardial extraction

Linear relationship between uptake and flow

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Literature review current through: Nov 2017. | This topic last updated: Nov 24, 2017.
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