Clinical InvestigationImaging and Diagnostic TestingPrognostic utility of single-photon emission computed tomography in adult patients with hypertrophic cardiomyopathy
Section snippets
Study population
The Mayo Foundation Institutional Review Board approved this study. The study population consisted of 180 consecutive patients with HCM who underwent MPI at the Mayo Clinic (Rochester, MN) between January 1986 and September 2000. Patients <18 years (n = 7) were excluded. Other exclusion criteria were resting scan only (n = 3), history of either percutaneous coronary intervention (PCI) (n = 6) or coronary artery bypass graft (CABG) (n = 4), and refusal of research authorization (n = 2), leaving
Baseline characteristics
Mean age was 60 ± 16 years (range 18-88 years). Most (61%) patients were men and had Canadian Cardiovascular Society (CCS) class III/IV angina (53%). History of myocardial infarction and history of diabetes mellitus were present in 8% and 10% of the patients, respectively. Mean maximal wall thickness was 19 ± 5 mm. A significant LVOT gradient (≥30 mm Hg gradient at rest or ≥50 mm Hg with provocation) was present in 37 (23%) patients. Other characteristics are listed in Table I. The reasons for
Discussion
Because of inherent abnormalities in the myocardial substrate, patients with HCM are prone to ischemia. Single-photon emission computed tomography MPI is a noninvasive measure of myocardial ischemia with established prognostic capabilities in patients with coronary atherosclerosis. Myocardial perfusion imaging has been examined in pediatric patients with HCM, but data on its ability to risk stratify adult patients with HCM are limited.
The current investigation examined the prognostic
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2013, Academic RadiologyCitation Excerpt :Many HCM patients develop myocardial perfusion abnormalities in multiple segments of the left ventricle. This phenomenon has been demonstrated by myocardial scintigraphy, used to estimate the risk of cardiovascular events, in individuals free of epicardial coronary artery disease (25). Kaimoto et al (26) reported that the semiquantification of scintigraphic defects in the anterior junction reflecting myocardial fibrosis yielded significant prognostic values, suggesting that the absence of the perfusion defect is linked to a very low risk of cardiovascular events.