Reversibility by dipyridamole of thallium-201 myocardial scan defects in patients with sarcoidosis
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), Vol. 85:2
- Country of Publication:
- United States
- Language:
- English
Similar Records
Critically ischemic myocardium in clinically stable patients following thrombolytic therapy for acute myocardial infarction: Potential implications for early coronary angioplasty in selected patients
Dipyridamole-induced ST segment depression during thallium-201 imaging in patients with coronary artery disease: angiographic and hemodynamic determinants
Related Subjects
CARDIOVASCULAR DISEASES
DIAGNOSIS
MYOCARDIUM
SCINTISCANNING
VASODILATORS
BIOLOGICAL EFFECTS
PATIENTS
PERFUSED ORGANS
THALLIUM 201
BETA DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR AGENTS
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DISEASES
DRUGS
ELECTRON CAPTURE RADIOISOTOPES
HEART
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MUSCLES
NUCLEI
ODD-EVEN NUCLEI
ORGANS
RADIOISOTOPE SCANNING
RADIOISOTOPES
SECONDS LIVING RADIOISOTOPES
THALLIUM ISOTOPES
550601* - Medicine- Unsealed Radionuclides in Diagnostics