Comparison of thallium-201 scanning in idiopathic dilated cardiomyopathy and severe coronary artery disease.

Abstract

SUMMARY To determine whether cardiomyopathy could be distinguished from coronary artery disease, we used thallium scanning to study 25 patients with severe left ventricular dysfunction and chronic heart failure. Ten patients had normal coronary arteries and idiopathic cardiomyopathy (ejection fraction 20 + 5 %), and 15 patients had multivessel coronary disease and left ventricular dysfunction (ejection fraction 25 + 6%). The exercise time and maximal heart rate were similar in the two groups. Two patients with cardiomyopathy and 11 with coronary artery disease had a positive exercise ECG (p < 0.05). Thallium scans showed perfusion defects in all 25 patients. The perfusion defects were complete in nine coronary artery disease patients (60%) and in one patient (10%) with cardiomyopathy (p < 0.05). Extensive defects involving more than 40% of the left ventricular circumference, the number of segments involved, redistribution on the 4-hour scan, lung uptake and ventricular size were similar in the two groups. Perfusion defects on thallium scanning can occur in patients with idiopathic dilated cardiomyopathy and chronic heart failure. Thallium scanning cannot be reliably used in patients with chronic heart failure to distinguish coronary artery disease from cardiomyopathy unless complete defects are present.

Prevention of cardiomyopathy in mouse models lacking the smooth muscle sarcoglycan-sarcospan complex

“…This is further supported by recent studies, which showed that familiar and sporadic cases of dilated cardiomyopathy caused by mutations within the δ-sarcoglycan gene can occur even in the absence of significant skeletal muscle problems (7). Therefore, screening for mutations should also include patients without a primary skeletal muscle involvement but who have been reported to have an idiopathic cardiomyopathy associated with myocardial ischemia in the absence of atherosclerotic coronary artery disease (24)(25)(26)(27). Identification of novel mutations and characterization of the associated phenotypes would eventually warrant treatment trials with verapamil in these patients.…”

Prospective validation of a quantitative method for differentiating ischemic versus nonischemic cardiomyopathy by technetium‐99m sestamibi myocardial perfusion single‐photon emission computed tomography

“…Prior scintigraphic studies, all based on visual analysis, have observed that patients with ischemic cardiomyopathy tend to have myocardial perfusion defects of more substantial mag- nitude than do patients with nonischemic cardiomyopathy. [8][9][10][11][12][13][14][15][16][17] Because of the subjective nature of visual analysis, such studies do not provide objective guidelines for interpreting the results in any given patient. Hence, a quantitative approach to measuring perfusion defects was developed in this study.…”

“…In this current and in prior studies, the presence of defect reversibility was not found to be a reliable discriminator of ischemic from nonischemic cardiomyopathy. 9,10,16 Group: Retrospective (top) Prospective ( …”

I Diretriz da Sociedade Brasileira de Cardiologia Sobre Cardiologia Nuclear

“…Os defeitos transitórios da perfusão miocárdica são fortemente indicativos de etiologia isquêmica, da mesma forma que os defeitos persistentes em correspondência aos territórios coronarianos e que comprometem grandes áreas do ventrí-culo esquerdo (>40% da massa miocárdica). Os defeitos fixos restritos à região apical são exceção a essa regra 46,[88][89][90] . A ventriculografia radioisotópica também pode ser útil no diagnóstico diferencial entre as duas condições uma vez que na forma idiopática ambos os ventrículos costumam estar envolvidos, enquanto na cardiopatia isquêmica o envolvimento habitualmente restringe-se ao ventrículo esquerdo 91 .…”