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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
08:13

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography

Published on: February 16, 2016

[Electrocardiographic left ventricular hypertrophy without echocardiographic abnormalities evaluated by myocardial

M Narita1, T Kurihara

  • 1Department of Cardiology, Sumitomo Hospital, Osaka.

Journal of Cardiology
|February 2, 2000
PubMed

Insights

Myocardial perfusion and fatty acid imaging reveal abnormalities in patients with electrocardiographic left ventricular hypertrophy but normal echocardiograms. These imaging techniques help identify a pathological process similar to hypertrophic cardiomyopathy in some patients.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Pathophysiology

Background:

  • Electrocardiographic (ECG) left ventricular hypertrophy (LVH) with ST-T changes can occur without echocardiographic abnormalities.
  • The underlying pathophysiologic processes in these patients are not fully understood.
  • Investigating these subtle cardiac changes is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To investigate the pathophysiologic process in patients with ECG-LVH and ST-T changes but normal echocardiograms.
  • To evaluate the utility of myocardial perfusion imaging and fatty acid metabolic imaging in identifying cardiac abnormalities in this patient group.

Main Methods:

  • Exercise stress 99mTc-methoxy-isobutyl isonitrile (MIBI) perfusion imaging and rest 123I-beta-methyl-p-iodophenyl pentadecanoic acid (BMIPP) metabolic imaging were performed in 59 patients.
  • Patients included those with ECG-LVH, with or without hypertension and echocardiographic hypertrophy.
  • Coronary angiography and left ventricular myocardial biopsy were performed in a subset of patients.

Main Results:

  • Transient perfusion abnormalities and apical defects on 123I-BMIPP imaging were more frequent in normotensive patients compared to hypertensive patients (32% vs 17% for perfusion, 62% vs 30% for BMIPP).
  • 123I-BMIPP imaging revealed defects that were larger than perfusion abnormalities.
  • Myocardial biopsy specimens showed myocardial disarray with hypertrophy, without coronary stenoses.

Conclusions:

  • Many normotensive patients with ECG-LVH exhibit a pathological process resembling hypertrophic cardiomyopathy.
  • Myocardial perfusion and 123I-BMIPP imaging are valuable tools for identifying these subtle cardiac abnormalities.
  • These imaging modalities aid in differentiating patients with underlying pathology despite normal echocardiograms.

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