[Assessment of denervated but viable myocardium in patients with myocardial infarction--by myocardial imaging with 201Tl and 123I-MIBG].

The present study assessed sympathetic function in viable infarcted areas of the myocardium following the onset of myocardial infarction. The subjects were 19 patients with myocardial infarction. After exercise on a bicycle ergometer, simultaneous SPECT with Tl-201 and I-123 MIBG was performed. The behavior of MIBG following exercise remains to be clarified, but in the present study MIBG provided images different from those obtained with Tl. While the redistribution of Tl in the infarcted area was observed in 8 of 19 patients, MIBG was absent in the infarcted area in both the initial and delayed scans. In the patient undergoing CABG, the infarcted area showed no MIBG despite the normal perfusion of Tl. The previous proposal that the redistribution of Tl indicates myocardial viability to some extent suggests that the sympathetic function of the area of the myocardium showing the redistribution of Tl decreases even though the area is viable. These findings indicate that after the onset of myocardial infarction, there is a denervated but viable area in the myocardium, despite the viability demonstrated by Tl imaging. They also indicate that concurrent myocardial imaging with MIBG is useful for the detection of such a myocardium.