Assessment of left ventricular function and volumes for patients with dilated cardiomyopathy using gated myocardial perfusion SPECT and comparison with echocardiography

AIMLeft ventricular function, volumes and regional wall motion provide valuable diagnostic information and are of long-term prognostic importance in patients with dilated cardiomyopathy (DCM). This study was designed to compare the effectiveness of two-dimensional echocardiography and gated single photon emission computed tomography (SPECT) to evaluate these parameters in patients with DCM. METHODSGated SPECT and two-dimensional echocardiography were performed in 45 patients with DCM, and in 10 normal subjects as the control group. Patients were divided into two groups according to the aetiology of DCMgroup I, ischaemic DCM (n=30); group II, non-ischaemic DCM (n=15). All patients and the control group underwent resting myocardial gated SPECT, 45 min after injection of 555 MBq of Tc-methoxyisobutyl-isonitrile (Tc-MIBI). Gated SPECT data, including left ventricular volumes and left ventricular ejection fraction (LVEF), were processed using an automated algorithm. Simpsonʼs method was used to evaluate these parameters. Regional wall motion was evaluated using both modalities and scored using a 16-segment model with a five-point scoring system. Perfusion defects were expressed as a percentage of the whole myocardium planimetered by a bullʼs-eye polar map of composite non-gated SPECT. Myocardial perfusion was scored using a 16-segment model with a four-point scoring system. RESULTSMean perfusion defects and perfusion defect scores were 25±13% and 1.12±0.36 in group I and 4±8% and 0.76±0.26 in group II (P