RESUMO
In this study, we have compared scintigraphic and echocardiographic data in order to investigate whether increased septal perfusion represents asymmetrical septal hypertrophy (ASH), which is a symptom followed in the scintigraphy of myocardial perfusion. The study consists of a total of 186 patients (120 females and 66 males with an average age of 59.45 ± 11.54 years) who had normal myocardial perfusion scintigraphy and echocardiography examinations. Statistical comparison of septal wall thickness measurements obtained from echocardiography and septal-to-lateral wall ratios (S/L ratio) was performed scintigraphically. Left ventricular mass values were obtained as both scintigraphic and echocardiographic data and their correlations were evaluated in order to assess the presence of left ventricular hypertrophy (LVH). In statistical analyses, the values of interventricular septal thickness in diastole (IVSd), left ventricle posterior wall thickness in diastole (LVPWd), left ventricle mass (LVM), and left ventricle mass index (LVMI) were found to be significantly higher in group 2 (S/L ratio >1) compared to group 1 (S/L ratio <1). In addition, S/L ratio is significantly correlated with echocardiographic IVSd, LVPWd, LVM, LVMI, and scintigraphic LVM (rest) values. Furthermore, echocardiographic LVM and LVMI values were significantly correlated with LVM and LVMI values obtained from scintigraphy. It should be known that increased S/L ratio that can be monitored during scintigraphic studies can be an indicator of septal hypertrophy and/or LVH, however, further examination and close follow-ups should be performed in necessary cases.
RESUMO
PURPOSE: To evaluate septal perfusion and contractility in patients with left bundle branch block (LBBB). METHODS: Twenty patients were submitted to myocardial scintigraphy with Tecnecium-99m isontrile after exercise and dipyridamole infusion. The septal contractility was observed during the radionuclide ventriculography. All patients were submitted to coronariography. RESULTS: Twenty patients were studied and 17 (85) had a normal left anterior descending (LAD) artery. Nine (53) patients had abnormalities in septal perfusion after the exercise and 2 (12) after dipyridamole infusion. All patients had abnormalities in septal contractility during the radionuclide ventriculography. CONCLUSION: The myocardial scintigraphy after dipyridamole infusion showed better specificity in the diagnosis of a LAD lesion. The radionuclide ventriculography was an efficient method to evaluate the septal contraction abnormalities in patients with LBBB
Objetivo - Avaliar a perfusão e a contratilidade do septo-interventricular nos pacientes com bloqueio de ramo esquerdo (BRE). Métodos - Foram estudados, prospectivamente, 20 pacientes que realizaram o estudo da perfusão do miocárdio através da cintilografia com isonitrila ligada ao Tecnécio-99m, após o esforço e à infusão de dipiridamol. A contratilidade do septo-interventricular foi analisada pelo estudo da função ventricular com radionuclideos. Todos os pacientes realizaram cinecoronariografia. Resultados - Dos 20 pacientes, 17 (85%) apresentavam a artéria coronária descendente anterior (DA) normal. Destes, 9 (53%) mostravam alterações na perfusão septal após o esforço e 2 (12%) após a infusão de dipiridamol. Todos apresentaram assincronismo da contração septal à ventriculografia com radionuclídeos (VR). Conclusão - A cintilografia do miocárdio após a infusão de dipiridamol apresentou maior especificidade no diagnóstico de lesão obstrutiva na DA. A VR mostrouse método eficaz para comprovar o assincronismo de contração septal nos pacientes com BRE
