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DETERMINATION OF REGIONAL MYOCARDIAL BLOOD FLOW (MBF) IN PATIENTS WITH ANGINAL PAIN

H. IMHOF , F. DORAU , H. MÖSSLACHER , J. SLANY , H. UMEK , and E. DEUTSCH

The method most generally employed for the determination of myocardial blood flow is the one involving the use of xenon.

Following coronary angiography, Xe133 was selectively injected into the coronary arteries. An Anger scintillation camera (Pho-Gamma III) served to measure radioactivity.

The impulses originating in the detector were first recorded in binary decimal code by means of a video tape recorder.

The data were transferred onto computer-compatible magnetic tape (Ampex) through play-back of the original tape by way of a 4096-channel analyzer. This supplies the basis for determining—computer (IBM 360/30) of the Medical Faculty of Vienna University—regional myocardial blood flow according to a specially developed program.

A multilevel scintigram, the value of which was enhanced by improving the image quality through background correction and digital filtering with Wiener filters, was used; based on these results and the coronary angiogram, the coordinates of the regions of interest were established and the regional myocardial blood flow calculated.

At the same time, global myocardial flow was also determined; i.e., the rate showing an average value for the entire ventricle.

A total of 20 persons was examined. For technical reasons the data obtained for 2 of them could not be used.

Even in the control group (with normal coronary angiogram) there were major fluctuations in the regional myocardial blood supply. Patients with angina pectoris, with or without coronary stenosis, revealed greater deviations from mean values which, in themselves, changed little.

Following sublingual administration of nitroglycerin, repetition of the examinations disclosed distinctly lower values for regional myocardial blood flow.

In our opinion global determination by itself inevitably results in erroneous interpretations and misunderstandings when evaluating the clinically relevant myocardial blood flow rates.


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