Exercise- or dipyridamole-loaded QGS is useful to evaluate myocardial ischemia and viability in the patients with a history of Kawasaki disease.
BACKGROUND
Evaluation of myocardial ischemia and viability is very important for the management of patients with a history of Kawasaki disease (KD). (99m)Tc-tetrofosmin myocardial perfusion scintigraphy combined with quantitative gated single photon computed emission tomography (QGS) gives us information, not only about perfusion, but also the percentage change in left ventricular wall thickness (%WT) and relative changes in left ventricular wall motion (LVM).


METHODS
The subjects were 27 patients with a history of KD followed as outpatients at the National Cardiovascular Center, Osaka, Japan. Exercise-loaded QGS was performed on 21 patients, and dipyridamole- loaded QGS was performed in six patients younger than 7 years old.


RESULTS
Perfusion defects (PD) were observed in 12 patients. Of the 12 patients, four with old myocardial infarction (OMI) had decreased %WT. All patients with OMI showed a decrease in %WT in the areas where PD was seen on the image. The other eight patients without OMI showed no decrease in %WT. In non-infarcted cases, the %WT was normal in the PD-positive area.


CONCLUSIONS
It is possible to evaluate myocardial ischemia and viability in KD patients by comparing PD on the image with %WT determined by QGS using exercise or drug-loaded myocardial scintigraphy alone.
Ishikawa
Yuichi
Y
Department of Pediatrics and Reproductive, Pediatric & Infection Science, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan. y-ishika@yamaguchi-u.ac.jp
Fujiwara
Motoki
M
Ono
Yasuo
Y
Tsuda
Etsuko
E
Matsubara
Tomoyo
T
Furukawa
Susumu
S
Echigo
Shigeyuki
S
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D023921:Coronary Stenosis / Q000150:complications; D004176:Dipyridamole; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*; D009203:Myocardial Infarction / Q000150:complications; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D014022:Tissue Survival; D015899:Tomography, Emission-Computed, Single-Photon; D014665:Vasodilator Agents
D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D014665:Vasodilator Agents; C078700:technetium tc-99m tetrofosmin; D004176:Dipyridamole