Michihiro Narita1, Tadashi Kurihara. 1. Department of Cardiology, Sumitomo Hospital, Osaka, Japan. michihiro-narita@sumishobilkan.co.jp
Abstract
PURPOSE: Myocardial imaging with I-123-beta-methyl-p-iodophenyl-methylpentadecanoic acid (BMIPP) is useful for predicting the outcome of patients with hypertrophic cardiomyopathy (HCM). But its usefulness in asymptomatic patients is unclear. MATERIALS AND METHODS: Eighteen patients with asymptomatic HCM were examined with BMIPP and exercise stress perfusion imaging and then followed for 4.0 +/- 0.8 years. Extent of the defect (total defect score, TDS) and myocardial uptake of BMIPP (%uptake) were calculated to evaluate the BMIPP images. RESULTS: In the first study abnormal findings in the BMIPP and perfusion images were detected of 67 and 22% of the patients, respectively. In the second BMIPP study, the TDS had increased (2.1 +/- 2.7 to 4.1 +/- 4.9, p < 0.005) and the %uptake had decreased (5.67 +/- 0.88% to 4.81 +/- 0.91%, p < 0.001), but there were no differences in myocardial perfusion between the first and second study. Exertional dyspnea developed in 17% of the patients, and they were among the one third of the patients with the greatest reduction of %uptake. This group also showed deterioration of left ventricular (LV) %fractional shortening and LV volume in the second study. CONCLUSIONS: Abnormal findings on BMIPP images were frequently observed in patients with asymptomatic HCM, and these abnormal findings progressed with time. The greater reduction of %uptake during the follow-up period reflects the deterioration of the LV function.
PURPOSE: Myocardial imaging with I-123-beta-methyl-p-iodophenyl-methylpentadecanoic acid (BMIPP) is useful for predicting the outcome of patients with hypertrophic cardiomyopathy (HCM). But its usefulness in asymptomatic patients is unclear. MATERIALS AND METHODS: Eighteen patients with asymptomatic HCM were examined with BMIPP and exercise stress perfusion imaging and then followed for 4.0 +/- 0.8 years. Extent of the defect (total defect score, TDS) and myocardial uptake of BMIPP (%uptake) were calculated to evaluate the BMIPP images. RESULTS: In the first study abnormal findings in the BMIPP and perfusion images were detected of 67 and 22% of the patients, respectively. In the second BMIPP study, the TDS had increased (2.1 +/- 2.7 to 4.1 +/- 4.9, p < 0.005) and the %uptake had decreased (5.67 +/- 0.88% to 4.81 +/- 0.91%, p < 0.001), but there were no differences in myocardial perfusion between the first and second study. Exertional dyspnea developed in 17% of the patients, and they were among the one third of the patients with the greatest reduction of %uptake. This group also showed deterioration of left ventricular (LV) %fractional shortening and LV volume in the second study. CONCLUSIONS: Abnormal findings on BMIPP images were frequently observed in patients with asymptomatic HCM, and these abnormal findings progressed with time. The greater reduction of %uptake during the follow-up period reflects the deterioration of the LV function.
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