Radionuclide techniques for evaluating dilated cardiomyopathy and ischemic cardiomyopathy.
OBJECTIVE
To assess the clinical significance of radionuclide techniques in evaluating dilated cardiomyopathy (DCM) and ischemic cardiomyopathy (CAD-CM).


METHODS
28 patients with DCM and 55 patients with CAD-CM were studied. All patients underwent 99mTc-MIBI myocardial perfusion SPECT and 18F-FDG myocardial metabolic PET. 78 patients had 99mTc-RBC radionuclide ventriculography and 68 patients had coronary angiography.


RESULTS
The results of 23 patients (82%) with DCM showed mild and non-segmental distribution perfusion abnormalities. 52 patients with CAD-CM (95%) showed perfusion abnormalities that distributed along the coronary vessel territories. Significant perfusion defects were found in 4 patients with DCM (14%) and 45 patients with CAD-CM (82%) (P < 0.01). The average perfusion score was 4.5 +/- 2.6 in DCM and 9.6 +/- 2.5 in CAD-CM and the area of diminished perfusion was significantly smaller in DCM than in CAD-CM (P < 0.001). Two patients with DCM and 18 patients with CAD-CM had metabolic defects. The patterns of perfusion/metabolic imaging showed mismatch in most patients with CAD-CM but match in most patients with DCM. The LVEF in patients with DCM and CAD-CM was both decreased but the decreases were not statistically different between DCM and CAD-CM. The RVEF in patients with DCM was significantly lower than that in patients with CAD-CM (32.4% +/- 13.9% vs 40.9% +/- 15.4%, P < 0.05).


CONCLUSIONS
The radionuclide techniques are helpful for distinguishing DCM from CAD-CM. The segmental perfusion abnormality and RVEF are the most important factors for differentiation of DCM from CAD-CM.
Tian
Y
Y
Department of Nuclear Medicine, Cardiovascular Institute and Fu Wai Hospital, CAMS and PUMC, Beijing 100037, China.
Liu
X
X
Shi
R
R
Liu
Y
Y
Wu
Q
Q
Zhang
X
X
D000328:Adult; D009202:Cardiomyopathies / Q000000981:diagnostic imaging*; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging*; D005260:Female; D015637:Gated Blood-Pool Imaging; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging / Q000379:methods; D019275:Radiopharmaceuticals
D019275:Radiopharmaceuticals