How is the Ischemic Results on Myocardial Perfusion Scintigraphy Influence the Echocardiographic Parameters

Year 2010, Volume: 17 Issue: 3, 175 - 178, 01.06.2010

Funda Üstün Hülya Gürbüz Gülay Durmuş Altun Armağan Altun

Abstract

Single photon emission computed tomography (SPECT) imaging with 99mTc sestamibi is used to assess the location or the extent of myocardial ischemia. Echocardiography has the ability to evaluate wall motion, measurement of left ventricular (LV) volumes and ejection fraction (EF). The goal of this study was to compare measurements of left ventricular geometry parameters in ischemic and non-ischemic patients along with SPECT and echocardiography. Consecutive 78 patients (mean age 47±14 years, 38 males, 40 females) with suspected coronary artery disease were enrolled. In all patients, SPECT and good-quality echocardiographic recordings were studied retrospectively. Patients were divided into two groups: ischemic (n=27) and non-ischemic (n=51) according to MPS. All patients examined according to the study protocol, which included registration of weight, height, sex and echocardiography data. Echocardiographic parameters were also compared with MPS. Only end diastolic left ventricular diameter (EDLVD) was significantly higher in the ischemic group than in the nonischemic group (5.1±0.6 vs 4.7±0.8; p<0.05). There was no significant difference in LVMI (109.8±45.2 vs 130.4±96.0, p>0.2); CO (4.6±2.4 vs 4.8±2.4, p>0.05); EF (59.9±11.0 vs 60.2±7.8, p>0.05); FS (23.1±14.2 vs 22.2±16.2, p>0.05); SWT (1.0±0.2 vs 1.0±0.3, p>0.05) and PWT (0.9±0.2 vs 1.0±0.3, p>0.05) parameters in echocardiography between patients with non-ischemic and ischemic, respectively. Echocardiographically, left ventricular diastolic diameters were significantly higher in patients with ischemic than in non-ischemic patients. Thus, these associated EDLVD differences have given important information about cascade of ischemic heart disease. Key words: CAD, Myocard Perfusion Scintigraphy, Echocardiography, End Diastolic Left Ventricular Diameter

Keywords

CAD, Myocard Perfusion Scintigraphy, Echocardiography, End Diastolic Left Ventricular Diameter

Miyokard Perfüzyon Sintigrafisinde İskemi Bulgusu Olması Ekokardiyografik Verileri Nasıl Etkiler?*

Abstract

Amaç: 99mTc sestamibi ile miyokard perfüzyon sintigrafisi (MPS) miyokard iskemisini değerlendirmede kullanılmaktadır. Ekokardiyografi ise miyokard duvar hareketlerinin, ventrikül volümünün ve ejeksiyon fraksiyonun (EF) ölçümünde kullanılır. Çalışmamızın amacı; MPS ile iskemik ve normal değerlendirilen hasta grupları arasında ekokardiyografi ile elde edilen sol ventrikül verilerini karşılaştırmaktı. Hastalar: Şüpheli KAH olan, hem ekokardiyografi hem de MPS yapılmış 78 hastanın (ortalama yaş 47±14 yıl, 38 erkek ve 40 kadın) verileri retrospektif olarak değerlendirildi. MPS sonucuna göre hastalar normal (=51) ve iskemik (=27) olarak iki gruba ayrıldı. Hastaların tüm verileri (yaş, cinsiyet, kilo, boy, vücut kitle endeksi) çalışıldı. Ayrıca ekokardiyografi verileri de MPS sonucuna göre karşılaştırıldı. Sonuçlar: Hasta grupları arasında demografik veriler arasında anlamlı fark yoktu. Hasta grupları arasında ekokardiyografi verileri içinde sadece diastol sonu sol ventrikül çapı iskemik grupta (5.1±0.6) normal vakalara (4.7±0.8) göre anlamlı olarak yüksekti (p<0.05). Diğer ekokardiyografi verilerinde anlamlı farklılık yoktu (sırasıyla normal ve iskemik hastalar): (1) LVMI (109.8±45.2 ile 130.4±96.0, p>0.2); (2) CO (4.6±2.4 ile 4.8±2.4, p>0.05); (3) EF (59.9 ±11.0 ile 60.2±7.8, p>0.05); (4) FS (23.1±14.2 ile 22.2±16.2, p>0.05); (5) SWT (1.0±0.2 ile 1.0±0.3, p>0.05), (6) PWT (0.9±0.2 ile 1.0±0.3, p>0.05). Tartışma: Ekokardiyografi sonucuna göre sol ventrikül diastolik çap iskemik hastalarda normallere göre geniştir. Bu bulgu iskemik kalp hastalığının süreci hakkında önemli bulgu sağlamaktadır. Anahtar kelimeler: Koroner arter hastalığı, miyokard perfüzyon sintigrafisi, ekokardiyografi, diastol sonu sol ventrikül çapı

Keywords

Koroner arter hastalığı, miyokard perfüzyon sintigrafisi, ekokardiyografi, diastol sonu sol ventrikül çapı

References

• Underwood SR, Anagnostopoulos C, Cerqueira M, et. al. Myocardial perfusion scintigraphy: the evidence. Eur J Nucl Med Mol Imaging 2004;31:261-91.
• Klocke FJ, Baird MG, Lorell BH, et. al. ACC/AHA/ASNC guidelines for the clinical use of cardiac radionuclide imaging-- executive summary: a report ofthe American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASNC Committee to Revise the 1995 Guidelines for the Clinical Use of Cardiac Radionuclide Imaging). J Am Coll Cardiol 2003;42:1318-33.
• Lima RS, De Lorenzo A, Pantoja MR, Siqueira A. Incremental prognostic value of myocardial perfusion 99m-technetium- sestamibi SPECT in the elderly. Int J Cardiol 2004;93:137-43.
• Kurrelmeyer KM. Noninvasive evaluation of women with coronary artery disease. Curr Opin Cardiol 2002;17:464-9.
• Shaw LJ, Iskandrian AE. Prognostic value of gated myocardial perfusion SPECT. J Nucl Cardiol 2004;11:171-85.
• Fukuda S, Hozumi T, Watanabe H, Muro T, Yamagishi H, Yoshiyama M, Takeuchi K, Yoshikawa J. Freehand three- dimensional echocardiography with rotational scanning for measurements of left ventricular volume and ejection fraction in patients with coronary artery disease. Echocardiography 2005;22:111-9.
• Berman DS. Fourth annual Mario S. Verani, MD Memorial Lecture: noninvasive imaging in coronary artery disease: changing roles, changing players. J Nucl Cardiol 2006;13:457-73.
• Slama M, Maizel J. Echocardiographic measurement of ventricular function. Curr Opin Crit Care 2006;12:241-8.
• Berk F, Isgoren S, Demir H, Kozdag G, Sahin T, Ural D, Kahraman G. Assessment of left ventricular function and volumes for patients with dilated cardiomyopathy using gated myocardial perfusion SPECT and comparison with echocardiography. Nucl Med Commun 2005;26:701-10.
• Henneman MM, Schuijf JD, van der Wall EE, Bax JJ. Non- invasive anatomical and functional imaging for the detection of coronary artery disease. Br Med Bull 2006;79-80:187-202.
• Bin JP, Le E, Pelberg RA, Coggins MP, Wei K, Kaul S. Mechanism of inducible regional dysfunction during dipyridamole stress. Circulation 2002;106:112-7.
• Hansen CL, Cen P, Sanchez B, Robinson R. Comparison of pulmonary uptake with transient cavity dilation after dipyridamole Tl-201 perfusion imaging. J Nucl Cardiol 2002;9:47-51.
• Udelson JE, Rajendran V, Leppo JA. In Nuclear Medicine in Clinical Diagnosis and Treatment; London: 1998.
• Schuijf JD, Poldermans D, Shaw LJ, Jukema JW, Lamb HJ, de Roos A, Wijns W, van der Wall EE, Bax JJ. Diagnostic and prognostic value of non-invasive imaging in known or suspected coronary artery disease. Eur J Nucl Med Mol Imaging 2006;33:93-104.
• Gibson DG, Traill TA, Brown DJ. Changes in left ventricular free wall thickness in patients with ischaemic heart disease. Br Heart J 1977;39:1312-8.