Valor del índice de excentricidad del ventrículo izquierdo con tomografía spect de perfusión miocárdica en diversas condiciones / Value of eccentricity index of left ventricle with miocardial SPECT perfusion tomography in several conditions

Introducción: El índice de excentricidad (IE) obtenido con SPECT miocárdico permite evaluación de esfericidad ventricular izquierda en remodelación patológica. Objetivo: conocer IE en adultos con diversas condiciones cardíacas. Método: Grupo I: Controles (n=44) con >2 factores de riesgo cardiovascular exceptuando Diabetes Mellitus (DM); Grupo II: DM 2 (n=41). Ambos grupos asintomáticos sin enfermedad coronaria conocida. Grupo III: Con alteración de motilidad segmentaria y/o infarto de miocardio (n=64). Grupo IV: Dilatados (n=21) con alteraciones de motilidad difusa o miocardiopatías. Se utilizó Sestamibi-Tc99m y procesamiento QGS. (IE esfera valor

Background: The Eccentricity Index (EI) obtained with myocardial SPECT allows adequate assessment of left ventricular shape in pathological myocardial remodeling. Aim: To compare EIs in adults with different cardiac conditions. Methods: 170 patients were studied. Group I (n=44) were control subjects with >2 cardiovascular risk factors not including Diabetes Mellitus (DM); Group II (n=41) had type II DM. Patients in both groups were asymptomatic without known coronary artery disease or wall motion abnormalities. Group III (n=64) had seg-mental wall motion abnormality and/or myocardial infarction; Group IV (n=21) included patients with dilated ventricles and diffuse abnormal wall motion. We used gated 99mTc Sestamibi SPECT and QGS processing (EI sphere

Brain perfusion abnormalities associated to drug abuse in recent abstinent patients using SPECT 99m Tc-ethylen-cysteinate-dimer (ECD)

Several substances may produce brain perfusion abnormalities in drug-dependent patients. Their mechanism is unclear and several causes might be involved, especially vasospasm in cocaine consumption. Goal: To characterize residual brain perfusion abnormalities in substance-dependent population. We analyzed brain perfusion in 100 dependant patients (DSM-IV criteria) following a month of strict in-hospital abstinence (age:35 +/- 2y.o.; 86 percent men); 55 percent corresponded to poly-drug dependents, mainly to cocaine, alcohol and cannabis; 44 percent mono-drug users, mostly to alcohol. Results: Single Photon Emission Computed Tomography (SPECT) with 99mTc-ethylen-cysteinate-dimer (ECD) was abnormal in 54 percent of the cases, with bilateral cortical hypo-perfusion in 89 percent, focal in 54 percent and diffuse in 46 percent of them, with moderate or severe intensity in 61 percent. The abnormal perfusion group’s age was 38 +/- 12 versus 31 +/- 10 years in the normal SPECT group (P=0.005) with a consumption period of 16 +/- 11 versus 11 +/- 8 years, respectively (P=0.043). Only 29 percent of women had abnormal perfusion versus 58 percent of men (P=0.047). Abnormal brain perfusion in 64 percent of mono and 45 percent in poly-drug dependents (P=0.07). Psychometric tests performed in 25 patients demonstrated association between perfusion defects and cognitive abnormalities. Relative risk for abnormal psychometric test was 2.5 [95 percent;CI=1.1-5.6] for abnormal SPECT. Conclusion: Dependent population after a month of abstinence persists with cortical brain perfusion abnormalities, associated to age, sex and type of drug consumption.