Myocardial Impairment Detected by Late Gadolinium Enhancement in Hypertrophic Cardiomyopathy: Comparison with 99mTc-MIBI/Tetrofosmin and 123I-BMIPP SPECT
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概要
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Purpose: Myocardial fibrosis is considered to be an important factor in myocardial dysfunction and sudden cardiac death in hypertrophic cardiomyopathy (HCM). The purpose of this study was to compare myocardial fibrosis detected by late gadolinium enhancement (LGE) on cardiac MRI with myocardial perfusion and fatty acid metabolism assessed by single photon emission computed tomography in HCM.Materials and Methods: We retrospectively evaluated 20 consecutive HCM patients (female, 7; mean age, 53.4 years) who underwent LGE, technetium-99m methoxyisobutylisonitrile/tetrofosmin (99mTc-MIBI/tetrofosmin), and iodine-123 beta-methyl-iodophenylpentadecanoic acid (123I-BMIPP) imaging. We calculated the myocardium-to-lumen signal ratio (M/L) for LGE in 17 segments based on the American Heart Association statement. Scoring of 99mTc-MIBI/tetrofosmin (PI) and 123I-BMIPP (BM) was performed for each segment using a 5-point scale (0, normal; 4, highly decreased).Results: Nineteen of 20 patients (95%) and 153 of 340 segments (45%) showed LGE. M/Ls were 0.420.16, 0.550.17, and 0.650.24 in PI0/BM0, PI0/BM1-4 and PI1-4/BM1-4, respectively. All M/Ls were significantly higher than that of a normal control (0.340.14) (p<0.001).Conclusions: Myocardial fibrosis in HCM can occur despite normal perfusion and fatty acid metabolism, and is more strongly associated with disorders of fatty acid metabolism than with perfusion abnormalities. M/L may be a useful indicator of disease severity.
- 神戸大学の論文
- 2013-00-00
著者
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Noguchi Teruo
Department Of Cardiology National Cardio Vascular Center
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Kiso Keisuke
Department of Cardiology, Moriya Daiichi General Hospital
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Yamada Naoaki
Department Of Cardiology Mie University Graduate School Of Medicine
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Ishibashi-ueda Hatsue
Department Of Cardiology Pathology Organ Transplantation And Nuclear Medicine National Cardiovascula
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Kono Atsushi
Department Of Medicine Institute Of Clinical Endocrinology
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Morita Yoshiaki
Department Of Diagnostic Radiology Tohoku University Graduate School Of Medicine
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Naito Hiroaki
Department Of Analytical Radiology Center Osaka University
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Higashi Masahiro
Department Of Cardiovascular Medicine Kyoto Prefectural University Of Medicine
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Fukushima Kazuto
Department Of Nuclear Medicine National Cardiovascular Center
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SUGIMURA Kazuro
Department of Biomedical Informatics, Division of Radiology, Kobe University Graduate School of Medicine
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Naito Hiroaki
Department of Radiology, National Cerebral and Cardiovascular Center
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Hashimura Hiromi
Department of Radiology, Kobe University Graduate School of Medicine
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Yamada Naoaki
Department of Radiology, National Cerebral and Cardiovascular Center
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Ishibashi-Ueda Hatsue
Department of Pathology, National Cerebral and Cardiovascular Center
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Higashi Masahiro
Department of Radiology, National Cerebral and Cardiovascular Center
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Morita Yoshiaki
Department of Radiology, National Cerebral and Cardiovascular Center
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Noguchi Teruo
Department of Cardiovascular medicine, National Cerebral and Cardiovascular Center
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Fukushima Kazuto
Department of Radiology, National Cerebral and Cardiovascular Center
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KONO Atsushi
Department of Chemical Engineering, Waseda University, Japan
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