[Correlation of various types of perfusion defects with supraventricular and ventricular arrhythmias in hypertrophic cardiomyopathy].
To ascertain the relationship between the types of myocardial perfusion defects and supraventricular and ventricular tachyarrhythmias in hypertrophic cardiomyopathy (HCM), 26 patients were studied with dipyridamole-loading thallium-201 scintigraphy and the results were correlated with 24-hour ambulatory ECG, echocardiograms and hemodynamic data. Myocardial perfusion defects were detected in 10 of the 26 patients (38%); three with large defects (LD) and seven with multiple small defects (SD). The patients with defects had greater degree of asymmetric septal hypertrophy (1.82 +/- 0.49 vs 1.27 +/- 0.38, p less than 0.01) and lower cardiac indices (2.35 +/- 0.31 vs 2.70 +/- 0.43, p less than 0.05) than did the patients without defects. Paroxysmal atrial fibrillation (PAf) and/or paroxysmal supraventricular tachycardia (PSVT) were observed in six of the 10 patients with defects (60%) and in four of the 16 patients without defects (25%). Ventricular tachycardia (VT) was identified in six of the 10 patients with defects (60%) but in only three of the 16 patients without defects (19%) (p less than 0.05). Among 10 patients with defects, PAf and/or PSVT were present in six of the seven patients with SD, but not in any of the patients with LD (p less than 0.05). VT was present in five of the seven patients with SD and in one of the three patients with LD. In conclusion, 1) perfusion defects in HCM are associated with greater degree of asymmetric septal hypertrophy, the lower cardiac indices, and higher prevalences of PAf, PSVT and VT; 2) Perfusion defects can be classified in two types; ie., multiple small defects and large defects; 3) Patients with multiple small defects commonly have PAf, PSVT as well as VT. This correlation may be of clinical importance, particularly in evaluating the causes of the defects and mechanisms of these arrhythmias.
Doi
Y
Y
Department of Medicine & Geriatrics, Kochi Medical School, Nankoku.
Yonezawa
Y
Y
Chikamori
T
T
Hamashige
N
N
Kuzume
O
O
Takata
J
J
Yamada
M
M
Ozawa
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D002648:Child; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D010477:Perfusion; D011877:Radionuclide Imaging; D013610:Tachycardia / Q000209:etiology*; D013617:Tachycardia, Supraventricular / Q000209:etiology; D013794:Thallium Radioisotopes
D013794:Thallium Radioisotopes