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Predicting the clinical course in hypertrophic cardiomyopathy using thallium-201 myocardial scintigraphy

Mareomi Hamada1, Yuji Shigematsu2, Shigeru Nakata3

  • 1Division of Cardiology, Uwajima City Hospital, 1-1 Goten-machi, Uwajima, Ehime, 798-8510, Japan.

ESC Heart Failure
|February 12, 2021
PubMed

Insights

Thallium-201 scintigraphy reveals significant left ventricular remodelling in hypertrophic cardiomyopathy (HCM) patients over time. The mean count change (MCC) metric may offer superior evaluation of these myocardial perfusion changes compared to the extent score (ES).

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Medical Imaging

Background:

  • Hypertrophic cardiomyopathy (HCM) is a complex cardiac condition.
  • Left ventricular remodelling is a key feature of HCM.
  • Monitoring remodelling progression is crucial for patient management.

Purpose of the Study:

  • To evaluate temporal changes in left ventricular remodelling in HCM patients.
  • To assess the utility of thallium-201 myocardial scintigraphy in tracking these changes.
  • To compare the effectiveness of the extent score (ES) and mean count change (MCC) indices.

Main Methods:

  • Forty-eight HCM patients underwent thallium-201 myocardial scintigraphy.
  • Myocardial perfusion defects were quantified using extent score (ES) and mean count change (MCC).
  • Left ventricle was segmented to identify lesion sites; follow-up averaged 8.6 years.

Main Results:

  • Significant increases in both ES (17.4% to 44.0%) and MCC (0% to 12.0%) were observed (P < 0.0001).
  • The apex was the most common site for myocardial perfusion defects.
  • Higher ES and MCC values correlated with left ventricular heart failure (LVHF) and associated complications like atrial fibrillation and apoplexy.

Conclusions:

  • Thallium-201 myocardial scintigraphy effectively detects myocardial damage severity and lesion location in HCM.
  • The mean count change (MCC) metric shows promise for superior evaluation of temporal changes in myocardial perfusion.
  • These findings aid in understanding HCM progression and managing associated cardiovascular risks.
Abstract

Keywords:
Extent scoreHeart failureHypertrophic cardiomyopathyMean count changeThallium-201 myocardial scintigraphy

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