Analysis of apical remodeling in gated myocardial perfusion SPECT imaging in ischemic cardiomyopathy

Guillermo Romero-Farina, Jaume Candell-Riera, Santiago Aguadé-Bruix, Joan Castell-Conesa, Gustavo de León

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    9 Citations (Scopus)

    Abstract

    Background: A divergent pattern (DP) of the left ventricle (LV) is an expression of apical remodeling in myocardial perfusion gated single-photon emission computed tomography (SPECT) of patients with ischemic cardiomyopathy (ICM). Methods and Results: We consecutively studied 156 patients (mean age, 63 years; 24 women) with ICM (LV ejection fraction, ≤40%) using gated SPECT and technetium-labeled agents. Apical remodeling was considered to exist when a DP was observed. Apical remodeling was noted in 30% of patients, all of whom had a history of anterior myocardial infarction. A divergent pattern was observed more frequently in younger patients and in those with ST-segment elevation on their electrocardiograms. The longer the interval between the infarction and the performance of gated SPECT, the more prevalent were the LV dilatation and DP. A divergent pattern was associated with cardiac death and heart failure only in patients with scintigraphic criteria for myocardial viability. Conclusions: A divergent pattern in gated SPECT, as an expression of apical remodeling, can be observed in up to a third of patients with ICM, all with a history of anterior infarction. The longer the time between the infarction and the gated SPECT, the more prevalent the LV dilatation becomes. Apical remodeling is a variable predicts mortality in patients with scintigraphic criteria for viability. © 2008 American Society of Nuclear Cardiology.
    Original languageEnglish
    Pages (from-to)225-231
    JournalJournal of Nuclear Cardiology
    Volume15
    Issue number2
    DOIs
    Publication statusPublished - 1 Mar 2008

    Keywords

    • divergent pattern
    • Ischemic heart disease
    • prognostic
    • scintigram
    • systolic dysfunction
    • ventricular remodeling

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