Evaluation of left ventricular myocardial perfusion and function using gated SPECT in patients with hypertrophic obstruction cardiomyopathy following percutaneous transluminal septal myocardial ablation

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Abstract

Objective

This study was designed to evaluate the left ventricular myocardial perfusion and function in hypertrophic obstruction cardiomyopathy patients following percutaneous transluminal septal myocardial ablation (PTSMA) using rest single-photon emission computed tomography (SPECT) myocardial perfusion imaging.

Patients and methods

Thirty-five patients (24 men and 11 women, 48±11 years old) with hypertrophic obstruction cardiomyopathy underwent rest-gated 99mTc-MIBI SPECT imaging 4±10 days before (baseline) and 4.7±1.0 days (short-term) and 15.5±8.2 months (mid-term) after PTSMA. Semiquantitative and QGS quantitative evaluations of perfusion and function were carried out in 17 left ventricular segments.

Results

Myocardial perfusion of the septum following PTSMA was significantly reduced compared with baseline in all patients (P<0.05), but the myocardial perfusion in the basal septum was significantly higher at mid-term compared with short-term following PTSMA (P<0.05). Left ventricular ejection fraction was significantly decreased following PTSMA (P<0.05). Regional wall motion assessed in the basal anterior, basal septum, and basal inferior areas following PTSMA was significantly reduced compared with baseline (P<0.05), and wall thickening of the interventricular septum was decreased following PTSMA (P<0.05).

Conclusion

Rest-gated SPECT imaging can be used to assess left ventricular myocardial perfusion and function and to investigate the efficacy of PTSMA during follow-up.

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