Captazione polmonare di tallio-201 a riposo e funzione diastolica in pazienti con cardiopatia ischemica e disfunzione ventricolare sinistra

Translated title of the contribution: Thallium-201 lung uptake at rest and diastolic function in patients with ischemic heart disease and left ventricular dysfunction

Claudio Marcassa, Michele Galli, Alessandro Imparato, Pier Luigi Temporelli, Pantaleo Giannuzzi

Research output: Contribution to journalArticlepeer-review

Abstract

An elevated thallium-201 lung uptake after stress is currently considered a marker of severe coronary artery involvement and related to adverse prognosis. The meaning of this scintigraphic finding on rest thallium-201 images is yet poorly investigated. We compared the thallium-201 lung uptake and the left ventricular diastolic function from mitral Doppler in 24 patients (64 ± 10 years) with ischemic heart disease and severe left ventricular dysfunction (ejection fraction 28 ± 10%). All patients underwent a 3-view planar rest-redistribution thallium-201 and 2D-echo studies within 6 days, while clinically stable. The amount of thallium-201 lung uptake was quantified as the ratio (L/H) between the activity in a left lung region of interest (L) and that observed in the left ventricle (H). From mitral Doppler, early (E) and late (A) filling velocities, the E/A ratio and the deceleration time of early filling (DecT) were calculated. An elevated L/H (≤ 0.54) was observed in 9 patients (37%). They showed a lower ejection fraction (20 ± 4% vs 33 ± 10% in patients with normal L/H; p <0.01) and a higher wall motion score index (2.5 ± 0.4 vs 2.1 ± 0.4, p <0.05). A significant inverse linear relation was observed between L/H and the left ventricular ejection fraction (r = -0.70); no significant relation was observed between L/H and left ventricular end-diastolic volumes or wall motion score index. A significant linear relation was also observed between L/H and E/A (r = 0.74; p <0.001) as well as L/H and DecT (r = -0.61; p <0.001); an even stronger, inverse, relation was found between L/H and A (r = -0.81; p <0.001). An abnormal L/H identified 80% of patients with a restrictive filling pattern (specificity 93% and accuracy 88%, respectively). In conclusion, in stable patients with ischemic heart disease and ventricular dysfunction, L/H on rest thallium-201 images is closely correlated with Doppler indexes of left ventricular diastolic filling dynamic; an abnormal L/H is highly predictive of a restrictive filling pattern.

Translated title of the contributionThallium-201 lung uptake at rest and diastolic function in patients with ischemic heart disease and left ventricular dysfunction
Original languageItalian
Pages (from-to)1005-1011
Number of pages7
JournalGiornale Italiano di Cardiologia
Volume28
Issue number9
Publication statusPublished - Sep 1998

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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