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Gated SPECT in patients with hypertrophic obstructive cardiomyopathy undergoing transcoronary ethanol septal ablation
- Source :
- Journal of Nuclear Cardiology. 9:594-600
- Publication Year :
- 2002
- Publisher :
- Springer Science and Business Media LLC, 2002.
-
Abstract
- Transcoronary ethanol septal ablation (TESA) is a novel treatment for obstructive hypertrophic cardiomyopathy (HOCM). Our objective was to evaluate the use of gated single photon emission computed tomography (SPECT) in patients with HOCM and the effects of TESA on myocardial perfusion.We performed gated SPECT and Doppler echocardiography before and 6 weeks after TESA in 30 patients with severe HOCM. The lung-to-heart and septal-to-lateral wall count-activity ratios were calculated. Before ablation, SPECT showed perfusion abnormalities in only 6 patients. Asymmetric septal hypertrophy was noted in 21 patients (70%). In patients with a lung-to-heart ratio greater than 0.50 before ablation, the ratio decreased from 0.56 +/- 0.04 to 0.45 +/- 0.08 after ablation (P.01). The septal-to-lateral wall ratio also decreased significantly after ablation. Mean Doppler pressure gradient across the left ventricular outflow tract decreased from 52 +/- 39 mm Hg to 13 +/- 13 mm Hg (P.01) immediately after ablation and to 10 +/- 21 mm Hg 6 weeks later (P.01). There were no significant changes in left ventricular ejection fraction by gated SPECT after the procedure. SPECT studies done after ablation showed fixed septal defects in 29 of 30 patients (96.7%). The defects involved the basal and mid septum in 100% and 38% of patients, respectively, and ranged in size from 2% to 30% of the left ventricle (mean, 8.8% +/- 7.0%).TESA is an effective technique for relieving left ventricular outflow obstruction in patients with HOCM. Myocardial gated SPECT can identify the presence and location of infarction after TESA.
- Subjects :
- Adult
Male
Cardiac Catheterization
medicine.medical_specialty
Adolescent
Gated SPECT
Myocardial Infarction
Single-photon emission computed tomography
Sensitivity and Specificity
Obstructive cardiomyopathy
Cohort Studies
Ventricular Dysfunction, Left
Drug Delivery Systems
Septal Ablation
Internal medicine
Myocardial perfusion scintigraphy
Heart Septum
medicine
Humans
Radiology, Nuclear Medicine and imaging
In patient
Aged
Aged, 80 and over
Ethanol
medicine.diagnostic_test
business.industry
Reproducibility of Results
Gated Blood-Pool Imaging
Cardiomyopathy, Hypertrophic
Middle Aged
Treatment Outcome
Cardiology
Female
Obstructive hypertrophic cardiomyopathy
Cardiology and Cardiovascular Medicine
business
Nuclear medicine
Perfusion
Subjects
Details
- ISSN :
- 10713581
- Volume :
- 9
- Database :
- OpenAIRE
- Journal :
- Journal of Nuclear Cardiology
- Accession number :
- edsair.doi.dedup.....028919e61327e514c87315d0b079f432