Document Detail


Adenosine Tc-99m tetrofosmin SPECT in differentiation of ischemic from nonischemic cardiomyopathy in patients with LV systolic dysfunction.
MedLine Citation:
PMID:  18580229     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The noninvasive differentiation of ischemic from nonischemic cardiomyopathy is clinically important. However, whether adenosine Tc-99m tetrofosmin SPECT can offer clear and accurate information was not known. The aim of this study is to investigate the usefulness of adenosine Tc-99m tetrofosmin SPECT in differentiation of ischemic from nonischemic etiology in patients with mild to severe LV systolic dysfunction and to compare the relationship between patients with mild LV systolic dysfunction and those with severe LV systolic dysfunction. METHODS: Seventy-five patients with chronic heart failure (LV ejection fraction <or=50%) underwent adenosine Tc-99m tetrofosmin SPECT and coronary angiography to identify ischemia. The patients were divided into 2 groups based on the result of ejection fraction (EF); group I (44 patients) had mild LV dysfunction, LVEF >35%, group II (31 patients) had severe LV dysfunction, LVEF <or=35%. As the result of SPECT, percent abnormal myocardium was categorized into 3 groups: small defect, <10%; medium defect 10% to 20%; and large defects, >or=20%. Myocardial ischemia was defined by >or=70% stenosis in at least one vessel by coronary angiography. RESULTS:: In group I, 4 (30.8%) of 13 patients with small defects, 1 (25.0%) of 5 patients with a medium defect, and 22 (84.6%) of 26 patients with large defects demonstrated myocardial ischemia documented by coronary angiography. The relationship between the extent of the SPECT defect and myocardial ischemia was statistically significant in the group I population (P < 0.001). However, in group II, 1 (33.3%) of 3 patients with small defect, 3 (33.3%) of 9 patients with medium defects, and 7 (36.8%) of 19 patients with large defects demonstrated myocardial ischemia confirmed by coronary angiography. There was no statistical relationship between the extent of the SPECT defect and myocardial ischemia in group II. CONCLUSIONS: Adenosine Tc-99m tetrofosmin SPECT is a useful modality to differentiate ischemic from nonischemic etiology in patients with mild LV systolic dysfunction. However, other noninvasive approaches other this SPECT may be considered for confirming the etiology in patients with severe LV systolic dysfunction.
Authors:
Sung Ho Her; Hee Jeoung Yoon; Jong Min Lee; Seung Won Jin; Ho Joong Youn; Ki Bae Seung; Jae Hyung Kim
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical nuclear medicine     Volume:  33     ISSN:  1536-0229     ISO Abbreviation:  Clin Nucl Med     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-26     Completed Date:  2008-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7611109     Medline TA:  Clin Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  459-63     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiomyopathies / diagnosis*,  pathology
Coronary Angiography / methods
Echocardiography / methods
Female
Heart Failure / diagnosis,  pathology
Humans
Male
Middle Aged
Myocardial Ischemia / diagnosis*,  pathology
Organophosphorus Compounds / diagnostic use*
Organotechnetium Compounds / diagnostic use*
Radiopharmaceuticals / diagnostic use*
Systole
Tomography, Emission-Computed, Single-Photon / instrumentation,  methods*
Ventricular Dysfunction, Left / diagnosis*,  pathology*
Chemical
Reg. No./Substance:
0/Organophosphorus Compounds; 0/Organotechnetium Compounds; 0/Radiopharmaceuticals; 0/technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane

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