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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

Absence of defects in SPECT thallium-201 myocardial images in patients with systemic hypertension and left

M P Cecil1, W C Pilcher, R L Eisner

  • 1Carlyle Fraser Heart Center, Emory/Crawford Long Hospital, Department of Medicine (Cardiology), Atlanta, Georgia 30365.

The American Journal of Cardiology
|July 1, 1994
PubMed

Insights

Hypertension and left ventricular hypertrophy do not cause abnormal thallium-201 SPECT myocardial perfusion imaging. This study found normal thallium-201 distribution in patients with hypertension, debunking artifact concerns.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Radiology

Background:

  • Hypertension is common in patients undergoing myocardial perfusion imaging.
  • Previous studies suggested hypertension-induced left ventricular hypertrophy can cause artifacts in thallium-201 SPECT imaging, mimicking myocardial infarction.
  • These artifacts, specifically diminished lateral/septal count ratios, were reported in up to 35% of patients with end-stage renal disease and left ventricular hypertrophy.

Purpose of the Study:

  • To evaluate myocardial SPECT thallium-201 distribution in a broader group of patients with hypertension-related left ventricular hypertrophy.
  • To determine the prevalence of abnormal thallium-201 SPECT studies in this patient population.
  • To compare the lateral/septal count ratio between hypertensive patients with left ventricular hypertrophy and normal subjects.

Main Methods:

  • Compared average thallium-201 counts in myocardial regions of male patients with hypertension and left ventricular hypertrophy (n=16) to normal male subjects (n=49).
  • Focused analysis on the lateral and septal walls to calculate the lateral/septal count ratio.
  • Assessed stress and delayed imaging for abnormalities, defining defects as ratios more than 2.0 standard deviations below normal limits.

Main Results:

  • The mean lateral/septal wall count ratio was 4.4% lower in the hypertensive group (1.09 +/- 0.07) compared to the normal group (1.14 +/- 0.07; p < 0.01).
  • At 3-hour delay, the lateral/septal count ratio was similar between the study group (1.06 +/- 0.09) and the normal group (1.08 +/- 0.06; p = NS).
  • Crucially, no patient exhibited a defect, and all thallium-201 studies were interpreted as normal.

Conclusions:

  • Myocardial thallium-201 distribution is normal in patients with left ventricular hypertrophy resulting from hypertension.
  • Hypertension-induced left ventricular hypertrophy does not lead to clinically significant artifacts on thallium-201 SPECT myocardial perfusion imaging.
  • The findings suggest that previously reported artifacts may be overestimated or specific to certain patient subgroups.

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