title: Significance of abnormal myocardial perfusion scintigraphy in young adult patients with SLE.
abstract: OBJECTIVE
  Detection of subclinical coronary artery disease (CAD) is a potential challenge in patients with systemic lupus erythematosus (SLE) and it is suggested that myocardial perfusion single photon emission computerized tomography (SPECT) is more sensitive than exercise test in this setting. However, the significance of perfusion abnormalities in SLE patients is not well known. In this study, we evaluated the prognostic significance of myocardial perfusion defects in patients with SLE.
  
  
  METHODS
  Patients with proven diagnosis of SLE admitted to the hospital due to noncardiac problems with no history of CAD were studied. All patients underwent (99m)Tc-MIBI myocardial perfusion scan using dipyridamole as pharmacological stress. All patients were followed up by reviewing patients file in lupus clinic and any minor or major cardiac events were recorded.
  
  
  RESULTS
  Eighteen female and two male patients with mean age of 28.2 +/- 12.05 years were included. Six patients had mild reversible perfusion defects with mean summed difference score of 2.5 +/- 1.0. Pattern of reverse redistribution (reverse fill-in) was noted in three patients. Eleven patients had normal myocardial perfusion. Hypokinesia was noted in three patients on gated images. One patient with abnormal perfusion died 21 days after imaging due to non-cardiac cause. Nineteen patients were followed for a mean time of 39.2 +/- 16.0 months. No major or minor cardiac events were noted during follow-up. Three patients (one with abnormal perfusion) had at least one readmission during follow-up period.
  
  
  CONCLUSIONS
  Our study showed that myocardial perfusion abnormalities are fairly frequent in SLE patients but the defects are generally mild and do not advocate an adverse prognosis.
authors.affiliation: Department of Nuclear Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Seyed Rasoul
authors.initials: SR
authors.lastname: Zakavi
authors.forename: Mohammad Hasan
authors.initials: MH
authors.lastname: Jokar
authors.forename: Vahid Reza Dabbagh
authors.initials: VR
authors.lastname: Kakhki
authors.forename: Ghodsieh
authors.initials: G
authors.lastname: Khazaei
authors.forename: Ramin
authors.initials: R
authors.lastname: Sadeghi
mesh_terms: D000293:Adolescent; D000328:Adult; D003326:Coronary Circulation; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D011379:Prognosis; D012189:Retrospective Studies; D015899:Tomography, Emission-Computed, Single-Photon; D055815:Young Adult