Document Detail


Evaluation of myocardial perfusion and function by gated SPECT in patients with Behçet's disease.
MedLine Citation:
PMID:  18535879     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Behçet's disease (BD) is a systemic multi-system vasculitis that can have a wide range of effects on the cardiovascular system. OBJECTIVE: To determine the existence of myocardial perfusion defects caused by coronary microvascular dysfunction in BD and to evaluate coronary arterial distribution and left ventricular systolic function by gated single-photon emission computed tomography (SPECT). METHODS: The study population consisted of 23 (15 men and 8 women) patients with BD and 20 healthy controls (12 men and 8 women). Technetium-99m methoxyisobutylisonitrile (Tc-99m MIBI) gated SPECT studies were performed at stress and rest in a 2-day protocol. Stress and rest left ventricular ejection fraction (LVEF) were calculated. Using non-gated SPECT images myocardial perfusion scores [summed stress score (SSS), summed rest score (SRS), summed difference score (SDS), and fix defect score (FDS)] and perfusion defect extent as percentage (stress, rest ischemic, and fix %LV) were determined. Using gated SPECT images, wall motion score indices (stress wall motion score indices and rest wall motion score indices) were calculated. Coronary angiography (CAG) was applied to patients with abnormal myocardial perfusion scintigraphy (MPS). RESULTS: The mean ages of the BD and control groups were 39.3 +/- 10.6 years and 36.2 +/- 8.3 years, respectively. No statistically significant differences were observed between the two groups regarding clinical features and cardiologic findings. Abnormal MPS was found in 13 (56.5%) of the BD patients; 3 patients had non-transmural infarcts and 10 patients reversible perfusion defects. Reversible perfusion defects were also found in two controls (10.0%). When the two groups were compared regarding the gated SPECT findings, differences were determined in the following parameters; SSS, SRS, SDS, FDS, stress and rest LVEF, stress and rest %LV, and stress and rest WMSI. In the BD group, when gated SPECT results were compared between those with and without abnormal MPS, differences were determined in SSS, SRS, SDS, FDS, stress and rest %LV, and stress and rest WMSI. Epicardial coronary arteries were normal in CAG. CONCLUSIONS: Myocardial perfusion and function are disturbed owing to influenced coronary microvascularity in BD, and CAG is frequently observed to be normal. Gated SPECT is a non-invasive reliable method that simultaneously evaluates the existence, extent and severity of myocardial ischemia or infarction and the wall movements in cardio-Behçet.
Authors:
Eser Kaya; Hayrettin Saglam; Ismail Ciftci; Mustafa Kulac; Semsettin Karaca; Mehmet Melek
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article     Date:  2008-06-06
Journal Detail:
Title:  Annals of nuclear medicine     Volume:  22     ISSN:  0914-7187     ISO Abbreviation:  Ann Nucl Med     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-06-06     Completed Date:  2008-09-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8913398     Medline TA:  Ann Nucl Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  287-95     Citation Subset:  IM    
Affiliation:
Department of Nuclear Medicine, Faculty of Medicine, Afyon Kocatepe University, Inönü Bulvari, Afyonkarahisar, Turkey. esermd@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Behcet Syndrome / physiopathology*,  radionuclide imaging*
Coronary Angiography
Coronary Circulation*
Exercise Test
Female
Gated Blood-Pool Imaging
Humans
Male
Middle Aged
Myocardial Contraction
Radiopharmaceuticals / pharmacokinetics
Stroke Volume
Technetium Tc 99m Sestamibi / pharmacokinetics
Tomography, Emission-Computed, Single-Photon
Ventricular Dysfunction, Left / physiopathology*,  radionuclide imaging*
Ventricular Function, Left
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi

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