Positive Correlation between Transient Left Ventricular Dilation and Reversible Perfusion Abnormality on Dipyridamole Thallium-201 Scintigraphy

Dipyridamole鉈－201閃爍攝影呈現暫時性左心室擴大與可逆性灌注異常之正相關性

蔡正道(Chen-Dao Tsai) ； 楊伯達(Po-Ta Yang) ； 陳宏德(Hon-Der Chen) ； 楊光道(Kuang-Tao Yang) ； 張柏齡(Po-Lin Chang) ； 洪光威(Guang-Uei Hung)

《核子醫學雜誌》 18卷2期 (2005/06) Pp. 77-83

https://doi.org/10.6332/ANMS.1802.002

摘要

Purpose: Transient left ventricular dilation (TLVD) during dipyridamole-stress myocardial perfusion imaging (MPI) has been postulated as an indicator of severe coronary artery disease and predictors of cardiac events. In this paper, the correlation between dipyridamole-induced TLVD and perfusion abnormalities on thallium-201 (201TI) single photon emission computed tomography (SPECT) was assessed and the underlying mechanisms of TLVD were discussed.
Methods: Ninety-four consecutive patients undergoing dipyridamole-stress 201TI MPI were enrolled for analysis. The myocardium was divided into 17 segments, and perfusion was scored on a 4-point scale (scores, 0-3 for normal to severe decrease). The ischemia score (IS score) and infarction score (IF score) were defined as the sum of the perfusion scores of segments with reversible and non-reversible perfusion abnormalities, respectively. TLVD was graded on a 3-point scale: D0=no dilation; Dl=mild dilation; D2=severe dilation.
Results: Fifty-five of the total 94 patients showed TLVD; of which 43 patients were mild (Dl) and 12 patients were severe (D2). The one-way ANOVA showed that IS scores were significantly different (DO=0.90±1.39, Dl=4.51±2.15, D2=14.25±4.48; P＜ 0.001) between D0, Dl, and D2 groups. Post hoc tests showed that Dl group had significantly higher IS scores than D0 group (P＜0.001), and D2 group had significantly higher IS scores than Dl group (P＜0.001). There is no significant difference for IF score between the three groups (D0=3.28±3.00, Dl=2.44±2.56, D2=3.08±3.18; P=0.394).
Conclusion: Transient left ventricular dilation (TLVD) during dipyridamole-stress 201TI imaging was significantly correlated to the extent and severity of reversible perfusion abnormality, but not to non-reversible one. These observations may suggest that dipyridamole-induced regional myocardial ischemia is responsible for the development of TLVD.

關鍵字

dipyridamole ； 鉈－201 ； 暫時性左心室擴大 ； 可逆性灌注異常

並列摘要

Purpose: Transient left ventricular dilation (TLVD) during dipyridamole-stress myocardial perfusion imaging (MPI) has been postulated as an indicator of severe coronary artery disease and predictors of cardiac events. In this paper, the correlation between dipyridamole-induced TLVD and perfusion abnormalities on thallium-201 (201TI) single photon emission computed tomography (SPECT) was assessed and the underlying mechanisms of TLVD were discussed.
Methods: Ninety-four consecutive patients undergoing dipyridamole-stress 201TI MPI were enrolled for analysis. The myocardium was divided into 17 segments, and perfusion was scored on a 4-point scale (scores, 0-3 for normal to severe decrease). The ischemia score (IS score) and infarction score (IF score) were defined as the sum of the perfusion scores of segments with reversible and non-reversible perfusion abnormalities, respectively. TLVD was graded on a 3-point scale: D0=no dilation; Dl=mild dilation; D2=severe dilation.
Results: Fifty-five of the total 94 patients showed TLVD; of which 43 patients were mild (Dl) and 12 patients were severe (D2). The one-way ANOVA showed that IS scores were significantly different (DO=0.90±1.39, Dl=4.51±2.15, D2=14.25±4.48; P＜ 0.001) between D0, Dl, and D2 groups. Post hoc tests showed that Dl group had significantly higher IS scores than D0 group (P＜0.001), and D2 group had significantly higher IS scores than Dl group (P＜0.001). There is no significant difference for IF score between the three groups (D0=3.28±3.00, Dl=2.44±2.56, D2=3.08±3.18; P=0.394).
Conclusion: Transient left ventricular dilation (TLVD) during dipyridamole-stress 201TI imaging was significantly correlated to the extent and severity of reversible perfusion abnormality, but not to non-reversible one. These observations may suggest that dipyridamole-induced regional myocardial ischemia is responsible for the development of TLVD.

並列關鍵字

dipyridamole ； 201TI ； transient left ventricular dilation ； reversible perfusion abnormality