Capabilities of 99mTc-pyrphotech single-photon emission computed tomography in combination with myocardial perfusion scintigraphy in the evaluation of inflammatory changes in the heart of patients with persistent atrial fibrillation


Cite item

Full Text

Abstract

AIM. To estimate the capabilities of 99mTc-pyrphotech single-photon emission computed tomography (SPECT) in the diagnosis of myocardial inflammatory changes in patients with persistent atrial fibrillation (AF). MATERIALS AND METHODS. Nineteen patients (11 males and 8 females, mean age 47.46±9.92 years) with persistent idiopathic AF underwent preoperative complete clinical and instrumental examination. 99mTc-pyrphotech SPECT was performed to identify foci of myocardial inflammatory changes. After completing 99mTC-pyrphotech scanning, resting myocardial perfusion scintigraphy with 99mTC-methoxyisobutylisonitrile (99mTc-MIBI) was performed in accordance with the standard protocol. The scintigrams obtained in both studies were then combined using the applied programs Jet Stream Workspace Release 2.5 (Philips) and the application Fusion. During invasive intervention, endomyocardial samples were intraoperatively taken from all the patients for histological and immunohistochemical examinations. RESULTS. Abnormal 99mTc-pyrphotech myocardial accumulation was found in 7 (36.8%) of the examinees, multiple foci in 3 cases and single foci in 4. Analysis of perfusion scintigrams indicated that the mean abnormal accumulation of 99mTc-MIBI in the left ventricle was 3.75±0.88% (maximum 9%).Histological examination of endomyocardial samples from 19 patients with persistent AF verified myocarditis in 4 (21%) patients and myocardial sclerosis concurrent with other abnormalities in 15 (78.9%) patients. CONCLUSION. Latent lymphocytic or polymorphic cellular myocarditis of viral etiology is a cause of idiopathic AF in 20% of the cases. 99mTc-pyrphotech scintigraphy may be one of the primary noninvasive diagnostic techniques for the detection of myocardial inflammation in this form of arrhythmia.

About the authors

S I Sazonova

ФГБУ "НИИ кардиологи" СО РАМН, Томск

Email: sazonova_si@mail.ru

Iu B Lishmanov

ФГБУ "НИИ кардиологи" СО РАМН, Томск

Email: zamdir@cardio-tomsk.ru

R E Batalov

ФГБУ "НИИ кардиологи" СО РАМН, Томск

Email: bre@cardio-tomsk.ru

S V Popov

ФГБУ "НИИ кардиологи" СО РАМН, Томск

Email: psv@cardio-tomsk.ru

Iu N Il'iushenkova

ФГБУ "НИИ кардиологи" СО РАМН, Томск

Email: biofizik85@mail.ru

Iu V Rogovskaia

ФГБУ "НИИ кардиологи" СО РАМН, Томск

M Z Idrisov

ФГБУ "НИИ кардиологи" СО РАМН, Томск

References

  1. Рекомендации ВНОК и ВНОА "Диагностика и лечение фибрилляции предсердий" 2011.
  2. Филатов А.Г., Тарашвили Э.Г. Эпидемиология и социальная значимость фибрилляции предсердий. Анналы аритмол 2012; 2: 5-13.
  3. Митрофанова Л.Б., Кудайбергенова А.Г., Антонова И.В. Фибрилляция предсердий, амилоидоз, миокардит и вирусная инфекция. Артериальная гипертензия 2009; 2: 203-208.
  4. Сторожаков Г.И., Гендлин Г.Е., Тронина О.А. Миокардиты. Сердеч недостат 2009; 1: 46-52.
  5. Гуревич М.А. Проблема некоронарогенных заболеваний миокарда в клинической практике Рус мед журн 1998; 6: 1523-1531.
  6. Jang S.Y., Cho Y., Song J.H. et al. Complication rate of transfemoral endomyocardial biopsy with fluoroscopic and two-dimensional echocardiographic guidance: a 10-year experience of 228 consecutive procedures. J Korean Med Sci 2013; 28 (9): 1323-1328.
  7. Strecker T., Rösch J., Weyand M., Agaimy A. Endomyocardial biopsy for monitoring heart transplant patients: 11-years-experience at a German heart center. Int J Clin Exp Pathol 2013; 6 (1): 55-65.
  8. Paul M., Stypmann J., Gerss J. et al. Safety of endomyocardial biopsy in patients with arrhythmogenic right ventricular cardiomyopathy: a study analyzing 161 diagnostic procedures. JACC Cardiovasc Interv 2011; 4 (10): 1142-1148.
  9. Sudoł-Szopińska I., Cwikła J.B. Current imaging techniques in rheumatology: MRI, scintigraphy and PET. Pol J Radiol 2013; 78 (3): 48-56.
  10. Lishmanov Yu.B., Sazonova S.I., Chernov V.I. et al. The scintigraphic diagnosis of inflammatory heart disease. Мед радиол и радиац безопасность 2004; 2: 59-66.
  11. Lishmanov Y., Minin S., Efimova I. et al. The possible role of nuclear imaging in assessment of the cardiac resynchronization therapy effectiveness in patients with moderate heart failure. Ann Nucl Med 2013; 27 (4): 378-385.
  12. Лишманов Ю.Б., Кривоногов Н.Г., Ильюшенкова Ю.Н. и др. Сцинтиграфическая оценка структурно-функциональных изменений миокарда и альвеолярно-капиллярной проницаемости легких у больных внебольничной пневмонией. Сиб мед журн 2011; 1: 106-109.
  13. Wynne J., Holman L.B., Lesch M. Myocardial Scintigraphy by infarct-avid radiotracers. Principles of cardiovascular nuclear medecine. New York: Grune and Stratton 1978; 230.
  14. Fuster V., Rydén L.E., Cannom D.S. et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation 2006; 114 (7): 257-354.
  15. Кривоногов Н.Г., Писарева Н.А., Лишманов Ю.Б. Сцинтиграфия миокарда в диагностике ИБС. Кардиология 1987; 27: 113-115.
  16. Быков В.Л. Цитология и общая гистология. Санкт-Петербург: СОТИС 2002.
  17. Aretz H.T., Billingham M.E., Edwards W.D. et al. Myocarditis: a histopathologic definition and classification. Am J Cardiovasc Pathol 1987; 1: 3-14.
  18. Basso C., Calabrese F., Angelini A. et al. Classification and histological, immunohistochemical and molecular diagnosis of inflammatory myocardial disease. Heart Fail Rev 2013; 18: 673-681.
  19. Митрофанова Л.Е., Карев В.Е. Миокардиты (стандарты морфологической диагностики при аутопсии и эндомиокардиальной биопсии). По ред. проф. Г.Б. Ковальского. Библиотека патологоанатома 2010; 115: 52.
  20. Richardson P., McKenna W., Bristow M. 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.
  21. Aviles R.J., Martin D.O., Apperson-Hansen C. et al. Inflammation as a risk factor for atrial fibrillation. Circulation 2003; 108: 3006-3010.
  22. Asselbergs F.W., Diercks G.F., van den Berg M.P. et al. C-reactive protein and microalbuminuria are associated with atrial fibrillation. JACC 2003; 41: 99-100.
  23. Dernellis J., Panaretou M. Relationship between C-reactive protein concentrations during glucocorticoid therapy and recurrent atrial fibrillation. Еur Heart J 2004; 25: 1100-1107.

Copyright (c) 2014 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies