title: Thallium-201 single-photon emission computed tomography: quantitative assessment of left ventricular perfusion and structural change in patients with chronic aortic regurgitation.
abstract: BACKGROUND
  Previously, perfusion defect in the left ventricle was detected by thallium-201 (201T1) single-photon emission computed tomography (SPECT) in aortic regurgitation (AR). The significance of 201T1 SPECT, however, has not been clarified. Limited information is available regarding the relationship between functional characteristics and scintigraphic findings.
  
  
  OBJECTIVE
  The purpose of this study was to elucidate the role of exercise 201T1 SPECT in assessing myocardial perfusion or structural change in chronic AR. We examined the correlation between 201T1 scintigraphic findings and left ventricular (LV) function parameters in 11 patients.
  
  
  METHODS
  Defect volume ratio (DVR) in exercise 201T1 SPECT was used as a parameter of the range of abnormal thallium distribution. Left ventricular parameters were obtained by right and retrograde left cardiac catheterizations. The relationship between DVR and the parameters was analyzed.
  
  
  RESULTS
  The DVR ranged from 1.0 to 28.3% (average 12.1 + 8.5 %). There was a significant correlation (r = 0.77, p < 0.05) between DVR and end-diastolic volume index (EDVI), a definite correlation (r = 0.66, p < 0.01) between DVR and end-systolic volume index (ESVI), and a good correlation (r = -0.77, p <0.05) between DVR and end-systolic wall stress (ESS)/ ESVI; however, no such correlation was found between DVR and ejection fraction.
  
  
  CONCLUSIONS
  All patients showed abnormal defects in 201T1 accumulation scattered across the entire ventricle. A strong correlation between DVR and ESS/ESVI, an index of myocardial contractility, was a major finding of this study, suggesting a significant association between abnormal myocardial perfusion or structural alteration and reduction in myocardial contractility in chronic AR.
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. hyasjj@ybb.ne.jp
authors.forename: Harumasa
authors.initials: H
authors.lastname: Yasuda
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Taniguchi
authors.forename: Toshiki
authors.initials: T
authors.lastname: Takahashi
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sawa
authors.forename: Hikaru
authors.initials: H
authors.lastname: Matuda
mesh_terms: D000328:Adult; D000368:Aged; D001022:Aortic Valve Insufficiency / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D006328:Cardiac Catheterization; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005080:Exercise Test; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013793:Thallium; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D013793:Thallium