[Pulmonary uptake of thallium-201 at rest and diastolic function in patients with ischemic cardiopathy and left ventricular dysfunction].
An elevated thallium-201 lung uptake after stress is currently considered a marker of severe coronary artery involvement and related to adverse prognosis. The meaning of this scintigraphic finding on rest thallium-201 images is yet poorly investigated. We compared the thallium-201 lung uptake and the left ventricular diastolic function from mitral Doppler in 24 patients (64 +/- 10 years) with ischemic heart disease and severe left ventricular dysfunction (ejection fraction 28 +/- 10%). All patients underwent a 3-view planar rest-redistribution thallium-201 and 2D-echo studies within 6 days, while clinically stable. The amount of thallium-201 lung uptake was quantified as the ratio (L/H) between the activity in a left lung region of interest (L) and that observed in the left ventricle (H). From mitral Doppler, early (E) and late (A) filling velocities, the E/A ratio and the deceleration time of early filling (DecT) were calculated. An elevated L/H (> or = 0.54) was observed in 9 patients (37%). They showed a lower ejection fraction (20 +/- 4% vs 33 +/- 10% in patients with normal L/H; p < 0.01) and a higher wall motion score index (2.5 +/- 0.4 vs 2.1 +/- 0.4, p < 0.05). A significant inverse linear relation was observed between L/H and the left ventricular ejection fraction (r = -0.70); no significant relation was observed between L/H and left ventricular end-diastolic volumes or wall motion score index. A significant linear relation was also observed between L/H and E/A (r = 0.74; p < 0.001) as well as L/H and DecT (r = -0.61; p < 0.001); an even stronger, inverse, relation was found between L/H and A (r = -0.81; p < 0.001). An abnormal L/H identified 80% of patients with a restrictive filling pattern (specificity 93% and accuracy 88%, respectively). In conclusion, in stable patients with ischemic heart disease and ventricular dysfunction, L/H on rest thallium-201 images is closely correlated with Doppler indexes of left ventricular diastolic filling dynamic; an abnormal L/H is highly predictive of a restrictive filling pattern.
Marcassa
C
C
Divisione di Cardiologia, IRCCS Fondazione Salvatore Maugeri, Veruno, NO.
Galli
M
M
Imparato
A
A
Temporelli
P L
PL
Giannuzzi
P
P
D000368:Aged; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D012146:Rest / Q000502:physiology; D013794:Thallium Radioisotopes; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000000981:diagnostic imaging*
D013794:Thallium Radioisotopes