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Myocardial damage following coronary bypass surgery: assessment with antimyosin antibody uptake

Nuclear Medicine, Hospital Reina Sofia, Cordoba, Spain ^* Cardiovascular Surgery Services, Hospital Reina Sofia, Cordoba, Spain

To assess the role of ¹¹¹In antimyosin antibody (AbAm) in the delineation of myocardial damage following coronary bypass surgery, we studied 51 consecutive patients who underwent coronary surgery, 27 of whom had a history of prior myocardial infarction. All patients underwent a diagnostic protocol comprising: (1) ⁹⁹Tc^m pyrophosphate (PYP) and AbAm injection 48 h after surgery (AbAm imaging 24 and 48 h post-injection) (myocardial/background and myocardial/lung ratios were obtained respectively from the computer image); (2) Radioimmunoassay (RIA) serum CK-B levels from samples obtained immediately before surgery, and 24 and 48 h later; (3) clinical and ECG follow-up. Twenty-five patients showed positive AbAm studies, 10 had positive PYP images, and 21 had CK-B levels above normal limits at 24 h. One patient with abnormal AbAm, PYP and CK-B studies had new Q waves on the ECG after surgery. This patient was considered to have sustained a peri-operative myocardial infarction. The large number of positive AbAm studies probably reflects myocardial damage frequently associated with coronary bypass surgery.

Key Words: Antimyosin antibody uptake • Myocardial damage • Coronary bypass surgery

Received for publication January 14, 1992. Accepted for publication August 10, 1992.