Reversibility by dipyridamole of thallium-201 myocardial scan defects in patients with sarcoidosis

Journal Article · Mon Aug 01 04:00:00 EDT 1988 · Am. J. Med.; (United States)

DOI:https://doi.org/10.1016/S0002-9343(88)80340-1· OSTI ID:6770720

Tellier, P; Paycha, F; Antony, I; Nitenberg, A; Valeyre, D; Foult, J M; Battesti, J P

In order to clarify the significance of anginal pain and myocardial thallium-201 scan defects in cardiac sarcoidosis, the pharmacologic effect of dipyridamole on myocardial perfusion was assessed by planar thallium-201 myocardial scintigraphy in patients with sarcoidosis. Thallium-201 myocardial scintigraphy was performed at rest and after 0.56 mg/kg intravenous dipyridamole during four minutes in 16 patients with sarcoidosis. The myocardial scan (45-degree and 70-degree left anterior oblique, and anterior views) was divided into 15 segments. Results were evaluated by the number of segmental defects and with a global perfusion score (from 0 to 60) by a semi-quantitative index depending on the size and severity of myocardial thallium-201 defects. Thirteen of the 16 patients showed partial or total reversion of their thallium-201 defects on redistribution scanning either at rest or after dipyridamole. The mean (+/- SD) number of myocardial perfusion defects that were present in all the patients decreased from 5.31 +/- 1.78 at rest to 3.25 +/- 2.52 after redistribution (p less than 0.001) and to 2.19 +/- 2.10 after dipyridamole (p less than 0.001). The mean global perfusion score increased from 53.2 +/- 3.0 at rest to 56.2 +/- 2.9 after redistribution (p less than 0.001) and to 57.2 +/- 2.7 after dipyridamole (p less than 0.001). A significant correlation (r = 0.82, p less than 0.001) was found between the increase of global perfusion score on redistribution and after dipyridamole. The reversibility of myocardial scan defects is a common finding in sarcoidosis. It makes unlikely the role of scar fibrosis or extensive confluent granulomas as a mechanism for such defects. The effect of dipyridamole suggests the presence of reversible disorders lying at the coronary microvascular level.

• Research Organization: Service of Nuclear Medicine, Chu Xavier Bichat, Paris (France)
• OSTI ID: 6770720
• Journal Information: Am. J. Med.; (United States), Journal Name: Am. J. Med.; (United States) Vol. 85:2; ISSN AJMEA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BIOLOGICAL EFFECTS
BODY
CARDIOVASCULAR AGENTS
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
DRUGS
ELECTRON CAPTURE RADIOISOTOPES
HEART
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MUSCLES
MYOCARDIUM
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATIENTS
PERFUSED ORGANS
RADIOISOTOPE SCANNING
RADIOISOTOPES
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
THALLIUM 201
THALLIUM ISOTOPES
VASODILATORS