The role of technetium‐99m sestamibi myocardial perfusion single‐photon emission computed tomography (SPECT) in the detection of cardiovascular involvement in systemic lupus erythematosus patients with non‐specific chest complaints

Abstract

(99m)Tc-sestamibi myocardial perfusion SPECT is a useful non-invasive imaging modality to detect cardiovascular involvement in SLE patients with non-specific clinical complaints of heart disease.

Accelerated Atherosclerosis in Autoimmune Rheumatic Diseases

“…Abnormalities of the coronary circulation have been reported in 40% of SLE patients by use of single photon emission computed tomography (SPECT) and dual isotope myocardial perfusion imaging (DIMPI) 32 and an even higher percentage (27 of 33 patients) by use of 99m Tc-SPECT. 33 Coronary artery calcifications were detected by electron beam CT in 31% of SLE patients, and the extent of calcification was particularly high in SLE patients compared with control subjects. 34 The most commonly used method for the detection of subclinical atherosclerosis is carotid B-mode ultrasound.…”

“…High prevalence of classic risk factors for atherosclerosis 11,13 , drugs used for treatment ͓methotrexate increase homocysteine 16 ͔ SLE High prevalence of CAD [24][25][26][27] , increased extent of subclinical atherosclerosis ͓ultrasound studies of carotid IMT [35][36][37][38][39] , coronary artery calcifications 34 , abnormalities in cardiac scintigraphy [32][33] ͔ High prevalence of classic risk factors for atherosclerosis 30 , corticosteroid therapy, long disease duration [25][26] …”

The incremental value of coronary artery calcium scores to myocardial single photon emission computer tomography in risk assessment

“…1 The visualizing of myocardial perfusion through myocardial SPECT is informative about hemodynamic changes in every stage of atherosclerosis, including early endothelial dysfunction, 2,3 intramyocardial microvessel disease, 4 and intermediate or high grade coronary artery stenoses. 5 Furthermore, non-atherosclerotic changes in myocardial perfusion such as the occurrence of left bundle blockinduced left ventricular dyssynchrony, 6,7 constrictive pericarditis, 8 or autoimmune diseases 9 can all be detected with myocardial SPECT. There is a vast literature indicating that the absence of perfusion abnormalities to myocardial SPECT predicts very low combined mortality, and nonfatal infarction rate of only about 1% per year, thus sparing many symptomatic patients the need for more invasive evaluation of their myocardial function.…”

Myocardial Ischaemia, Coronary Atherosclerosis and Pulmonary Pressure Elevation in Antiphospholipid Syndrome Patients

“…There is only a single study referring to PAPS. In SLE, perfusion defects were detected in 36−38% of asymptomatic patients [14,15], and when assessed globally in autoimmune diseases (such as SLE, RA and PAPS) it was slightly lower, 27% [13], despite normal rest ECG recordings and lack of myocardial ischaemia clinical symptoms. To the best of our knowledge, this is the first study which shows such a high frequency of myocardial perfusion defects in relatively young PAPS patients who were free from classic risk factors and symptoms of ischemic heart disease.…”