Usefulness of Tl-201 SPECT imaging in evaluation of left ventricular hypertrophy and dilation in patients with previous myocardial infarction.

Using short axis slices of Tl-201 myocardial SPECT images, total left ventricular (LV) mass, perfused LV mass, defect size, defect mass, ratio of total LV area to cavity area (T/C), ratio of radius of total LV area to radius of cavity area (TR/CR), and ratio of wall thickness to radius of cavity area (W/R) were obtained. The left ventricular ejection fraction (LVEF) was calculated using blood pool imaging studies. A total of 33 patients with old myocardial infarctions were studied. The patients were divided into group 1 (n = 16) with no history of heart failure, and group 2 (n = 17) with a history of heart failure. The LVEF (P less than 0.001), T/C (P less than 0.005), TR/CR (P less than 0.005) and W/R (P less than 0.001) were significantly lower, while the total LV mass (P less than 0.001) and perfused LV mass (P less than 0.01) were significantly higher in group 2. In the whole group of 33 patients, there was inverse linear correlation between the total LV mass and LVEF (r = -0.82), perfused LV mass and LVEF (r = -0.67), and defect mass and LVEF (r = -0.59). There was linear correlation between W/R and LVEF (r = 0.64). Nonlinear correlations were found between T/C and LVEF (r = 0.81) and TR/CR and LVEF (r = 0.80). Tl-201 myocardial SPECT imaging is useful for the evaluation of LV hypertrophy and cavity dilation in patients with previous myocardial infarction.