Abstract
Objective: The causes and prognostic significance of the reverse redistribution pattern (RRP) is not clear yet. In this study, we aimed to evaluate the RRP effect on the left ventricular ejection fraction (EF).Methods: Imaging of the patients whose technetium-99m sestamibi myocardial perfusion scintigraphy was carried out and reported as normal were retrospectively examined. One-day protocol and/or pharmacologic stress testing applied patients were excluded. 21 patients with RRP met the inclusion criteria. All of these patients were included in the study as RRP group. Randomly selected 21 patients with non-RRP were included in the study as control group. Transient ischemic dilation (TID) scores and EF values were automatically calculated with the Quantitative Gated SPECT (QGS) program. Results: While a statistically significant difference was not found between the RRP and control groups in terms of age, sex, hypertension, family history, hyperlipidemia, and diabetes (p>0.05), there was a statistically significant difference in terms of smoking (p=0.019). TID scores in the RRP group were significantly lower compared to the control group (p<0.001). In addition, a statistically significant decrease was determined in the EF values in the rest images compared to the stress images in the RRP group (p=0.002). Furthermore, this decrease was significantly higher than in the control group (p= 0.034). Conclusion: The results related to the TID scores and EF values are suggesting the existence of an ischemic cause in the background of the RRP. Additionally, the relationship found between smoking and RRP may be associated with the tachycardia and / or coronary spasm-inducing effect of smoking. J Clin Exp Invest 2015; 6 (3): 286-290
Keywords
Sestamibi myocardial perfusion reverse redistribution reverse distribution reverse perfusion
References
- 1. Pizzi MN, Sabaté-Fernández M, Aguadé-Bruix S, et al. Paradoxical scintigraphic pattern in regions with myocardial necrosis on myocardial perfusion gated SPECT with ⁹⁹mTc-tetrofosmin. J Nucl Cardiol 2012;19:515-523.
- 2. Shih WJ, Miller K, Stipp V, et al. Reverse redistribution on dynamic exercise and dipyridamole stress technetium-99m-MIBI myocardial SPECT. J Nucl Med 1995;36:2053-2055.
- 3. Schillaci O, Tavolozza M, Di Biagio D, et al. Reverse perfusion pattern in myocardial spect with 99mTcSestaMIBI. J Med Life 2013;6:349-354.
- 4. Kao CH, Wang SJ, Ting CT, Chen YT. ‘Reverse redistribution pattern’ during myocardial perfusion imaging with 99Tcm-MIBI. Nucl Med Commun 1996;17:397- 399.
- 5. Araujo W, DePuey EG, Kamran M, et al. Artifactual reverse distribution pattern in myocardial perfusion SPECT with technetium-99m sestamibi. J Nucl Cardiol 2000;7:633-638.
- 6. Smith EJ, Hussain A, Manoharan M, et al. A reverse perfusion pattern during Technetium-99m stress myocardial perfusion imaging does not predict flow limiting coronary artery disease. Int J Cardiovasc Imaging 2004;20:321-326.
- 7. Özeren A, Aydın M, Peksoy İ, ve ark. 99mTc-MIBI SPECT Miyokard perfüzyon görüntülemesinde revers redistribüsyon paterni: bir olgu dolayisiyla literatürün gözden geçirilmesi. MN Kardiyoloji 2004;11:145-148.
- 8. Xiang DC, Yin JL, He JX, Gong ZH. Resting chest pain, negative treadmill exercise electrocardiogram, and reverse redistribution in dipyridamole myocardial perfusion scintigraphy might be the features of coronary artery spasm. Clin Cardiol 2007;30:522-526.
- 9. Meka M, DePuey GE. Apparent reverse distribution of Tc-99m sestamibi on myocardial perfusion scan. J Nucl Cardiol 2007;14:e11-14.
- 10. Fragasso G, Chierchia SL, Dosio F, et al. Reverse perfusion pattern of Tc-99m MIBI heralding the development of myocardial infarction. Clin Nucl Med 1996;21:519-522.
- 11. Swinkels BM, Hooghoudt TE, Schoenmakers EA, et al. Clinical significance of reverse redistribution on technetium-99m tetrofosmin single-photon emission computed tomography: an 18-month follow-up study. Neth Heart J 2003;11:113-117.
- 12. Sudha ML, Sundaram S, Purushothaman KR, et al. Coronary atherosclerosis in sudden cardiac death: an autopsy study. Indian J Pathol Microbiol 2009;52:486- 489.
- 13. Yazdi SAT, Rezaei A, Azari JB, et al. Prevalence of atherosclerotic plaques in autopsy cases with noncardiac death. Iranian J Pathol 2009;4:101-104.
- 14. Garg M, Aggarwal AD, Kataria SP. Coronary atherosclerosis and myocardial infarction: an autopsy study. J Indian Acad Forensic Med 2011;33:39-42.
- 15. Sugiishi M1, Takatsu F. Cigarette smoking is a major risk factor for coronary spasm. Circulation 1993;87:76- 79
Tc-99m MIBI SPECT miyokard perfüzyon sintigrafisindeki revers redistribüsyon paterninin sol ventrikül ejeksiyon fraksiyonu üzerindeki etkisi
Abstract
Amaç: Revers redistribüsyon paterni (RRP)’nin nedenleri ve prognostik önemi henüz netlik kazanmamıştır. Bu çalışmada amacımız; RRP’nin sol ventrikül ejeksiyon fraksiyonu (EF) üzerindeki etkisini değerlendirmektir.
Yöntemler: Teknesyum-99m sestamibi miyokard perfüzyon sintigrafisi yapılmış ve normal olarak değerlendirilmiş hastaların görüntüleri retrospektif olarak incelendi. Tek gün protokolü ve/veya farmakolojik stres testi uygulanan hastalar çalışma dışı bırakıldı. RRP saptanan toplam 21 hasta çalışma kriterlerini sağladı. Bu hastaların tamamı RRP grubu olarak çalışmaya dahil edildi. Randomize seçilen 21 RRP saptanmayan hasta ise kontrol grubu olarak çalışmaya alındı. Transiyel iskemik dilatasyon (TID) skorları ve EF değerleri Quantitative Gated SPECT (QGS) programı kullanılarak otomatik olarak hesaplandı.
Bulgular: Yaş, cinsiyet, hipertansiyon, aile hikayesi, hiperlipidemi ve diyabet yönünden RRP ve kontrol grubu arasında istatistiksel olarak anlamlı bir fark saptanmazken (p>0,05), sigara kullanımı yönünden anlamlı fark tespit edildi (p=0,019). RRP grubundaki TID skorları, kontrol grubuna kıyasla anlamlı bir şekilde daha düşüktü (p<0,001). Ayrıca RRP grubunda, istirahat görüntülerindeki EF değerlerinde, stres görüntülerindekilere kıyasla anlamlı bir şekilde düşüş tespit edildi (p=0,002). Dahası bu düşüş, kontrol grubundakine kıyasla anlamlı bir şekilde daha yüksekti (p=0,034).
Sonuç: TID skoru ve EF değerleri ile ilgili bulgular, RRP zemininde iskemik bir nedenin varlığını düşündürmektedir. Ayrıca, sigara kullanımı ile RRP arasında saptanan ilişki; sigara kullanımının taşikardik atak ve/veya koroner spazm yapıcı etkisi ile ilişkili olabilir.
Anahtar kelimeler: Sestamibi, miyokardiyal perfüzyon, revers redistribüsyon, revers perfüzyon
References
- 1. Pizzi MN, Sabaté-Fernández M, Aguadé-Bruix S, et al. Paradoxical scintigraphic pattern in regions with myocardial necrosis on myocardial perfusion gated SPECT with ⁹⁹mTc-tetrofosmin. J Nucl Cardiol 2012;19:515-523.
- 2. Shih WJ, Miller K, Stipp V, et al. Reverse redistribution on dynamic exercise and dipyridamole stress technetium-99m-MIBI myocardial SPECT. J Nucl Med 1995;36:2053-2055.
- 3. Schillaci O, Tavolozza M, Di Biagio D, et al. Reverse perfusion pattern in myocardial spect with 99mTcSestaMIBI. J Med Life 2013;6:349-354.
- 4. Kao CH, Wang SJ, Ting CT, Chen YT. ‘Reverse redistribution pattern’ during myocardial perfusion imaging with 99Tcm-MIBI. Nucl Med Commun 1996;17:397- 399.
- 5. Araujo W, DePuey EG, Kamran M, et al. Artifactual reverse distribution pattern in myocardial perfusion SPECT with technetium-99m sestamibi. J Nucl Cardiol 2000;7:633-638.
- 6. Smith EJ, Hussain A, Manoharan M, et al. A reverse perfusion pattern during Technetium-99m stress myocardial perfusion imaging does not predict flow limiting coronary artery disease. Int J Cardiovasc Imaging 2004;20:321-326.
- 7. Özeren A, Aydın M, Peksoy İ, ve ark. 99mTc-MIBI SPECT Miyokard perfüzyon görüntülemesinde revers redistribüsyon paterni: bir olgu dolayisiyla literatürün gözden geçirilmesi. MN Kardiyoloji 2004;11:145-148.
- 8. Xiang DC, Yin JL, He JX, Gong ZH. Resting chest pain, negative treadmill exercise electrocardiogram, and reverse redistribution in dipyridamole myocardial perfusion scintigraphy might be the features of coronary artery spasm. Clin Cardiol 2007;30:522-526.
- 9. Meka M, DePuey GE. Apparent reverse distribution of Tc-99m sestamibi on myocardial perfusion scan. J Nucl Cardiol 2007;14:e11-14.
- 10. Fragasso G, Chierchia SL, Dosio F, et al. Reverse perfusion pattern of Tc-99m MIBI heralding the development of myocardial infarction. Clin Nucl Med 1996;21:519-522.
- 11. Swinkels BM, Hooghoudt TE, Schoenmakers EA, et al. Clinical significance of reverse redistribution on technetium-99m tetrofosmin single-photon emission computed tomography: an 18-month follow-up study. Neth Heart J 2003;11:113-117.
- 12. Sudha ML, Sundaram S, Purushothaman KR, et al. Coronary atherosclerosis in sudden cardiac death: an autopsy study. Indian J Pathol Microbiol 2009;52:486- 489.
- 13. Yazdi SAT, Rezaei A, Azari JB, et al. Prevalence of atherosclerotic plaques in autopsy cases with noncardiac death. Iranian J Pathol 2009;4:101-104.
- 14. Garg M, Aggarwal AD, Kataria SP. Coronary atherosclerosis and myocardial infarction: an autopsy study. J Indian Acad Forensic Med 2011;33:39-42.
- 15. Sugiishi M1, Takatsu F. Cigarette smoking is a major risk factor for coronary spasm. Circulation 1993;87:76- 79
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | October 25, 2015 |
| Published in Issue | Year 2015 |