This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Eguchi, M. Articles by Shimamoto, K. Search for Related Content PubMed PubMed Citation Articles by Eguchi, M. Articles by Shimamoto, K.

CLINICAL STUDY: ELECTROPHYSIOLOGY

Right ventricular abnormalities assessed by myocardial single-photon emission computed tomography using technetium-99m sestamibi/tetrofosmin in right ventricle-originated ventricular tachyarrhythmias

^a Second Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan

Manuscript received November 4, 1999; revised manuscript received May 15, 2000, accepted July 12, 2000.

Reprint requests and correspondence: Dr. Mariko Eguchi, Second Department of Internal Medicine, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-ku, Sapporo 060-0061, Japan
eguchi{at}sapmed.ac.jp

OBJECTIVES

We sought to determine whether right ventricular (RV) perfusion imaging with technetium-99m (Tc-99m) sestamibi or tetrofosmin single-photon emission computed tomography has diagnostic benefit for RV-originated ventricular tachyarrhythmias (RVT).

BACKGROUND

Identification of RV abnormalities is clinically important to establish RVT etiology.

METHODS

Forty-seven patients with RVT (23 with idiopathic and 24 with organic RVT due to arrhythmogenic RV or dilated cardiomyopathy, cardiac sarcoidosis or myocarditis) were compared to 25 control subjects. Right ventricular uptake score, as assessed by modified tomographic imaging, and regional RV count relative to peak left ventricular (LV) count (RV/LV count ratio) were compared with RV regional and global function.

RESULTS

Regional RV uptake score correlated well with the RV/LV count ratio, and segmental abnormality was more frequently (p = 0.001) detected in the organic RVT group (22 [92%] of 24 patients) than in the idiopathic RVT group (4 [17%] of 23 patients) or the control group (8 [32%] of 25 patients). The total RV score (8.4 ± 3.8) in the organic RVT group was significantly lower than that in the idiopathic RVT group (15.6 ± 1.6) or the control group (15.1 ± 1.8). The total RV score correlated with RV EF (r = 0.702, p < 0.001). A total RV score <12 differentiated the organic RVT group from the other two groups, with a sensitivity of 79% and a specificity of 100%. The asynergic RV regions had a significantly lower RV/LV count ratio and RV score as compared with the nonasynergic regions and were identified by RV assessment, with a sensitivity of 76.1% and a specificity of 76.6%.

CONCLUSIONS

Right ventricular perfusion tomography using a Tc-99m–labeled tracer is clinically useful for the noninvasive detection of RV myocardial damage in patients with RVT and for differentiating organic from idiopathic RVT.

Abbreviations and Acronyms   ARVC = arrhythmogenic right ventricular (dysplastic) cardiomyopathy   ECG = electrocardiogram or electrocardiographic   EF = ejection fraction   LV = left ventricle or ventricular   ROC = receiver operating characteristic   ROI = region of interest   RV = right ventricle or ventricular   RVT = right ventricle-originated ventricular tachyarrhythmia   Tc-99m = technetium-99m   VT = ventricular tachycardia

This article has been cited by other articles:

				F. C. Aepfelbacher, S. B. Yeon, K. K. L. Ho, J. A. Parker, and P. G. Danias ECG-Gated 99mTc Single-Photon Emission CT for Assessment of Right Ventricular Structure and Function: Is the Information Provided Similar to Echocardiography? Chest, July 1, 2003; 124(1): 227 - 232. [Abstract] [Full Text] [PDF]