CLINICAL USEFULNESS OF Tc-99m HEXAKIS 2-METHOXYISOBUTYL ISONITRILE GATED SPECT IN PATIENTS WITH DILATED CARDIOMYOPATHY: RETROSPECTIVE ANALYSIS
AbstractBackground: In Dilated cardiomyopathy the heart is enlarged and ventricles are dilated. Gatedmyocardial perfusion single photon emission computed tomography is considered state of the art formyocardial perfusion imaging. A retrospective analysis was conducted to evaluate patients with dilatedcardiomyopathy with Tc-99m sestamibi gated myocardial perfusion single photon emission computedtomography to evaluate its clinical utility. Methods: A 10 year retrospective medical record review wasdone from 1991 to 2001 at Wake Forest University, North Carolina, USA. Eligibility criteria included adiagnosis of dilated cardiomyopathy and availability of coronary angiography and Tc-99m sestamibicardiac imaging results. 26 cases were selected for the final review and inclusion in the study. Thestudy was done with standard protocols for cardiac sestamibi imaging. Results: A total of 26 caseswere included in the final analysis. Cases were divided into two main groups. Group-A included 16patients with no correlation between Tc-99m sestamibi and cardiac catheterisation reports. Group-Bincluded 10 patients with good correlation between the above tests. There were no significantdifferences between the left ventricular ejection fraction, angina history, sex distribution and diabeticstatus between the two groups. We applied Wilcoxon Signed Rank Test and z-test to quantify thedifference between the two groups. Data was tabulated and z-test was performed. The calculated pvalue was <0.0001. This is significantly less than the tabulated p-value at 5% level of significance, i.e.,1.96. Significant differences exist between Group-A and Group-B. Conclusion: Tc-99m sestamibi is anexcellent agent for investigating myocardial perfusion in dilated cardiomyopathy. The reversible andfixed perfusion defects (small to medium sized) seen in dilated cardiomyopathy after performance ofTc-99m sestamibi gated single photon emission computed tomography imaging may not be due tocoronary artery disease. Tc-99m sestamibi single photon emission computed tomography is useful as aroutine non-invasive technique to evaluate myocardial function in dilated cardiomyopathy.Keywords: Gated single photon emission computed tomography, dilated cardiomyopathy,sestamibi, positron emission tomography
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