[Extent and degree of coronary flow reserve in hypertrophic cardiomyopathy assessed by delta Fract map unfolding coronary flow reserve index].
Patients with hypertrophic cardiomyopathy (HCM) are known to have ischemic events and decreased coronary flow reserve, but the variabilities in the site and degree of fall between patients with this disease have not been clarified. To elucidate these variabilities, we performed exercise myocardial single photon emission computed tomography (SPECT) using double dose method in 30 patients with HCM (6 with obstruction, 17 with non-obstruction, 7 with apical hypertrophy) and 10 normals. Then, the delta Fract (coronary flow reserve index) map was obtained for each subject. Exercise and then rest Tl-201 myocardial scintigraphy were performed after administration of Tl-201. The data were reconstructed, making the circumferential curves from the same level of short-axis imaging during exercise and at rest. By subtracting the values at rest from the values during exercise, which were divided by the values at rest, delta Fract in each frame was obtained, and described on the unfolded map. The extent and degree of coronary flow reserve were visually estimated by this delta Fract map. Patients were categorized into 5 groups: diffuse fall of coronary flow reserve (D-type), 6 cases; localized fall of the septum or lateral wall (L-type), 5 cases; fall of apical region (A-type), 5 cases; mild fall (M-type), 6 cases; and normal pattern (N-type), 8 cases. We concluded that delta Fract map is useful for evaluating the extent and degree of coronary flow reserve in HCM.
Kubota
Y
Y
Department of Cardiology, Kyoto City Hospital.
Sugihara
H
H
Nakagawa
T
T
Shiga
K
K
Umamoto
I
I
Harada
Y
Y
Katahira
T
T
Asayama
J
J
Katsume
H
H
Nakagawa
M
M
D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003326:Coronary Circulation; D005080:Exercise Test; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008875:Middle Aged; D011237:Predictive Value of Tests; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D013794:Thallium Radioisotopes