Abstract
The purpose of this study was to clarify which myocardial histological findings associated with dilated cardiomyopathy (DCM) are reflected in quantitative201Tl myocardial SPECT. We obtained studied SPECT images from 21 patients with DCM 10 minutes and 2 hours after they received an injection of 111 MBq201Tl at rest. We calculated the percent coefficient of variation of myocardial201Tl counts [%CV(Tl)], the washout rate (WR), standard deviation of WR [SD(WR)], extent score (ES) and severity score (SS). We used image analysis to measure % fibrosis, % myocytes, the ratio of fibrous tissue to myocyte tissue (F/My), myocyte size and standard deviation of myocyte size [SD(My)] in left ventricular endomyocardial biopsy specimens. The %CV(Tl) was correlated with % fibrosis and F/My. The ES and SS also correlated with F/My. The correlation between SD(WR) and SD(My) was significant. The present findings suggest that %CV(Tl), ES and SS of rest201Tl SPECT reflect myocardial fibrosis and that the standard deviation of washout reflects the distribution of myocyte size.
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Shiotani H, Yamabe H, Fukuzaki H. The clinical and prognostic significance of dipyridamole Tl-201 emission computed tomography in patients with dilated cardiomyopathy.Jpn Circ J 1987; 51: 1016–1021.
Tamai J, Nagata S, Nishimura T, Yutani C, Miyatake K, Sakakibara H, et al. Hemodynamic and prognostic value of thallium-201 myocardial imaging in patients with dilated cardiomyopathy.Int J Cardiol 1989; 24: 219–224.
Doi Y, Chikamori T, Takata J, Yonezawa Y, Poloniecki JD, Ozawa T, et al. Prognostic value of thallium-201 perfusion defects in idiopathic dilated cardiomyopathy.Am J Cardiol 1991; 67: 188–193.
Bulkley BH, Hutchins GM, Bailey I, Strauss HW, Pitt B. Thallium 201 imaging and gated cardiac blood pool scan in patients with ischemic and idiopathic congestive cardiomyopathy: A clinical and pathologic study.Circulation 1977; 55: 753–760.
Saltissie S, Hockings B, Croft DN, Webb-Peploe MM. Thallium-201 myocardial imaging in patients with dilated and ischemic cardiomyopathy.Br Heart J 1981; 46: 290–295.
Dunn RF, Uren RF, Sadick N, Bautovich G, McLaughlin A, Hiroe M, et al. Comparison of thallium-201 scanning in idiopathic dilated cardiomyopathy and severe coronary artery disease.Circulation 1982; 66: 804–810.
Li L, Nohara R, Okuda K, Hosokawa R, Hata T, Tanaka M, et al. Comparative study of201Tl-scintigraphic image and myocardial pathologic findings in patients with dilated cardiomyopathy.Ann Nucl Med 1996; 10: 307–314.
Brandenburg RO, Chazov E, Cherian G, Falase AO, Grosgogeat Y, Kawai C, et al. Report of the WHO/ISFC task force on the definition and classification of cardiomyopathies.Br Heart J 1980; 44: 672–673.
Richardson P, McKenna W, Bristow M, Maisch B, Mautner B, O'Connell, et al. Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the definition and classification of cardiomyopathies.Circulation 1996; 93: 841–842.
Burow RD, Pond M, Schafer AW, Becker L. “Circumferential Profiles:” A new method for computer analysis of Thallium-201 myocardial perfusion images.J Nucl Med 1979; 20: 771–777.
Garcia EV, Train KV, Maddahi J, Prigent F, Freidman J, Areeda J, et al. Quantification of rotational thallium-201 myocardial tomography.J Nucl Med 1985; 26: 17–26.
Edwards WD. Myocarditis and endomyocardial biopsy.Cardiol Clin 1984; 2: 647–656.
Nunoda S, Genda A, Sekiguchi M, Takeda R. Left ventricular endomyocardial biopsy findings in patients with essential hypertension and hypertrophic cardiomyopathy with special reference to the incidence of bizarre myocardial hypertrophy with disorganization and biopsy score.Heart and Vessels 1985; 1: 170–175.
Nishikawa T, Sekiguchi M, Hasumi M, Kasajima T, Nakazawa M, Ando M, et al. Histopathologic findings of endomyocardial biopsies in pediatric patients with arrhythmias or conduction disturbances.Heart Vessels Suppl 1990; 5: 24–27.
Onodera T, Fujiwara H, Tanaka M, Wu DJ, Hamashima Y, Kawai C. Quantitative analysis of cardiac fibrosis in normal hearts, hearts with secondary eccentric hypertrophy and hearts with dilated cardiomyopathy.Card-Ang Bull (Cardiologisch-Angiologisches Bulletin) 1986; 3: 53–59.
Fujiwara H, Onodera T, Tanaka T, Fujiwara T, Kawai C, Hamashima Y. Number and size of myocytes, amount of interstitial space, fibrosis and disarray in dilated cardiomyopathy. [in Japanese].J Cardiography 1986; 16: 27–33.
Olsen EJG. Pathology of primary cardiomyopathies.Postgrad Med J 1972; 48: 732–737.
Roberts WC, Ferrans VJ, Buja LM. Pathologic aspects of the idiopathic cardiomyopathies.Adv Cardiol 1974; 13: 349–367.
Roberts WC, Siegel RJ, McMarrus BM. Idiopathic dilated cardiomyopathy: analysis of 152 necropsy patients.Am J Cardiol 1987; 60: 1340–1355.
Godfraind T, Noel F. Sodium activation of heart (Na++K+)-ATPase from normotensive and spontaneously hypertensive rats.Arch Int Pharmacodyn 1980; 245: 139–144.
David-Dufilho M. Quantitative changes in cardiac Na,K-ATPase of spontaneously hypertensive rats.J Cardiovasc Pharmacol 1984; 6: 273–280.
Takemura G, Takatsu Y, Fujiwara H. Luminal narrowing of coronary capillaries in human hypertrophic hearts: an ultrastructural morphometrical study using endomyocardial biopsy specimens.Heart 1998; 79: 78–85.
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Watanabe, M., Gotoh, K., Nagashima, K. et al. Relationship between thallium-201 myocardial SPECT and findings of endomyocardial biopsy specimens in dilated cardiomyopathy. Ann Nucl Med 15, 13–19 (2001). https://doi.org/10.1007/BF03012125
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DOI: https://doi.org/10.1007/BF03012125