Myocardial perfusion abnormalities in Eisenmenger syndrome

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Pulmonary Hypertension

Background:

• Eisenmenger syndrome patients exhibit prolonged right ventricular (RV) contractile function preservation compared to primary pulmonary hypertension (PPH).
• Myocardial perfusion differences are hypothesized to explain this survival discrepancy.
• The prevalence of myocardial perfusion abnormalities in Eisenmenger syndrome remains largely unknown.

Purpose of the Study:

• To investigate the prevalence of myocardial perfusion abnormalities in adult patients diagnosed with Eisenmenger syndrome.

Main Methods:

• Prospective study involving 20 consecutive adult Eisenmenger syndrome patients.
• Clinical assessment, six-minute walk test, and echocardiography were performed.
• Myocardial perfusion evaluated using one-day stress-rest Gated Technetium-99m Sestamibi SPECT.

Main Results:

• 95% of patients were New York Heart Association functional class I or II.
• All patients presented with RV hypertrophy; 25% had RV systolic dysfunction.
• Perfusion defects were observed in 10% of patients in the RV and 20% in the LV.

Conclusions:

• Myocardial perfusion defects are present in both the right and left ventricles of Eisenmenger syndrome patients.
• These perfusion abnormalities can occur even in patients who are asymptomatic or mildly symptomatic.