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Correlation studies were carried out between thallium-201 myocardial perfusion images and vectorcardiograms in 77 patients with myocardial infarction (48 anterior and 29 inferior infarctions) and 30 patients with hypertrophic cardiomyopathy. A quantitative method was developed; myocardial 201Tl uptake index (a relative myocardial activity to background, MUI) and myocardial 201Tl uptake ratio (a ratio of regional myocardial counts to maximal myocardial counts, MUR) were utilized to differentiate myocardial infarction from hypertrophic cardiomyopathy, and evaluate them. A fairly good agreement between left ventriculograms and myocardial perfusion images was obtained in myocardial infarction (diagnostic accuracy 95.1% in anterior and 75.6% in inferior infarction). In anterior infarction the linear relationship of r = -0.58 (p &lt; 0.001) was obtained between asynergy index and mean anterior MUR. A highly significant correlation was observed between anterior MUR and the instantaneous 24 msec Z component (r = -0.80, p &lt; 0.001). In inferior infarction, Qy/Ry was correlated to inferior MUR (r = -0.58, p &lt; 0.001). In hypertrophic cardiomyopathy, four types of hypertrophic sites were classified with 201Tl images (septal, apical and anterior, apical and septal, and anterior dominant types). Azimuth angles of instantaneous 10 msec vector were directed right-anteriorly (mean 114.5 degrees) in septal hypertrophy, and left-anteriorly (mean 84.9 degrees) in apical and anterior hypertrophy. Elevation angle of maximal T vector in apical hypertrophy was deviated superiorly (mean 102.6 degrees). There was a good correlation (r = 0.60, p &lt; 0.001) between the magnitude of spatial maximal QRS vector and lateral wall MUR.

The quantitative diagnosis of thallium-201 myocardial perfusion images and vectorcardiograms in myocardial infarction and hypertrophic cardiomyopathy.