99mTc-annexine V in patients with a heart disease. Detection of apoptosis by SPECT-imaging

Annexin V (36 kDa) is a protein with a high affinity for apoptotic expression of phosphatidylserine. In vivo visualisation of cell death after acute myocardial infarction would be of great interest. We studied in vivo cell death in the hearts of fifteen patients with an acute myocardial infarction using imaging with99mTc-labelled annexin V. Also, five patients with other myocardial disease were studied. Furthermore, pharmacokinetics and biodistribution of the two used99mTc-annexin V radiopharmaceuticals were studied. Pharmacokinetics could be described by a two-compartment model. The used radiopharmaceuticals are feasible for imaging in the thorax. In fourteen of fifteen patients with myocardial infarction, increased uptake of99mTc-annexine V was seen in the infarct area of the heart after performance of SPECT-imaging. In the five studied patients with myocardial disease, no myocardial uptake of99mTc-annexine V was found