[Myocardial perfusion SPECT and isotopic ventriculography in obstructive and non-obstructive hypertrophic myocardiopathy].
OBJECTIVE
To evaluate the role of myocardial perfusion SPET and radionuclide ventriculography in patients with hypertrophic cardiomyopathy (HC).


METHODS
Exercise myocardial perfusion SPET with 99mTc-tetrofosmin and radionuclide ventriculography were performed in a consecutive series of 101 patients (54 15 years, 50 women, 55 with dynamic obstruction) diagnosed of HC by echo. Follow-up from the diagnosis was 9,9 6,7 years (1 to 28 years).


RESULTS
Thirty six percent of patients had perfusion defects (non reversible in 15 and reversible in 21). In non obstructive HC higher number of patients with non reversible defects (p = 0.01 was obseved and in patients with no reversible defects higher incidence of pathologic Q waves in ECG (p = 0.01), Higher ventricular volumes (p < 0.05), lower ejection fraction (p = 0,0001) and longer time to peak emptying velocity (p < 0.05). There were 4 cardiac deaths, 15 syncopes, 18 pacemakers and 6 myectomy. Ejection fraction was higher in patients with syncope (p = 0,034) and there was no isotopic variable predictive of mortality, pacemaker or myectomy.


CONCLUSIONS
Neither SPET nor radionuclide ventriculography have a prognostic role in patients with HC, but patients with syncope have higher values of ejection fraction. Patients with non reversible defects have higher rate of pathologic Q waves in ECG, higher ventricular volumes and lower ejection fraction. This is indicative of evolution to dilated form of HC.
Romero-Farina
G
G
Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Candell-Riera
J
J
Pereztol-Valdés
O
O
Castell
J
J
Aguadé
S
S
Galve
E
E
Palet
J
J
Oller-Martínez
G
G
Armadans
L
L
Reina
D
D
Soler-Soler
J
J
D000328:Adult; D006332:Cardiomegaly / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D002311:Cardiomyopathy, Dilated / Q000209:etiology / Q000401:mortality; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D003326:Coronary Circulation; D018450:Disease Progression; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D010477:Perfusion; D011379:Prognosis; D015635:Radionuclide Ventriculography; D012189:Retrospective Studies; D013318:Stroke Volume; D015899:Tomography, Emission-Computed, Single-Photon