Resting “Solar Polar” map pattern and reduced apical flow reserve: characteristics of apical hypertrophic cardiomyopathy on SPECT myocardial perfusion imaging
✍ Scribed by R.Parker Ward; Hemlata K Pokharna; Roberto M Lang; Kim A Williams
- Publisher
- Springer
- Year
- 2003
- Tongue
- English
- Weight
- 216 KB
- Volume
- 10
- Category
- Article
- ISSN
- 1071-3581
No coin nor oath required. For personal study only.
✦ Synopsis
Background. Patients with apical hypertrophic cardiomyopathy (ACM) are often referred for myocardial perfusion single photon emission computed tomography (SPECT) as a result of marked T-wave inversion and chest pain syndromes. Stress perfusion defects have been reported in ACM, but the characteristic SPECT pattern as well as the typical findings on volume-weighted polar maps has not been described.
Methods and Results. Dual-isotope rest (thallium 201) and exercise or adenosine stress (technetium 99m tetrofosmin) myocardial perfusion SPECT was performed in 11 patients with ACM, including 8 with either normal coronary arteriography (n ؍ 5) or a low pretest probability of coronary artery disease (CAD) (n ؍ 3), and 14 control patients with concentric left ventricular hypertrophy. An 8-pixel-diameter circular region of interest was used to quantitatively compare apical and septal counts on CEqual volume-weighted polar maps. A characteristic "Solar Polar" map pattern resulting from the increased apical counts was present in each ACM patient at rest, with a mean apical-septal ratio of 1.39 ؎ 0.17 (range, 1.23-1.62, P < .01 vs concentric left ventricular hypertrophy group). With stress, there was a significant decrease in the apical-septal ratio (0.96 ؎ 0.18, P < .001 vs rest) in the ACM subgroup without CAD.
Conclusion.
Patients with ACM demonstrate a newly described "Solar Polar" map pattern at rest, as well as relative apical ischemia on the stress images even in the absence of CAD. (