Effect of the reverse redistribution pattern on the left ventricular ejection fraction in the Tc-99m MIBI SPECT myocardial perfusion scintigraphy

Abstract

Objective: The causes and prognostic significance of the reverse redistribution pattern (RRP) is not clear yet. In this study, we aimed to evaluate the RRP effect on the left ventricular ejection fraction (EF).Methods: Imaging of the patients whose technetium-99m sestamibi myocardial perfusion scintigraphy was carried out and reported as normal were retrospectively examined. One-day protocol and/or pharmacologic stress testing applied patients were excluded. 21 patients with RRP met the inclusion criteria. All of these patients were included in the study as RRP group. Randomly selected 21 patients with non-RRP were included in the study as control group. Transient ischemic dilation (TID) scores and EF values were automatically calculated with the Quantitative Gated SPECT (QGS) program. Results: While a statistically significant difference was not found between the RRP and control groups in terms of age, sex, hypertension, family history, hyperlipidemia, and diabetes (p>0.05), there was a statistically significant difference in terms of smoking (p=0.019). TID scores in the RRP group were significantly lower compared to the control group (p<0.001). In addition, a statistically significant decrease was determined in the EF values in the rest images compared to the stress images in the RRP group (p=0.002). Furthermore, this decrease was significantly higher than in the control group (p= 0.034). Conclusion: The results related to the TID scores and EF values are suggesting the existence of an ischemic cause in the background of the RRP. Additionally, the relationship found between smoking and RRP may be associated with the tachycardia and / or coronary spasm-inducing effect of smoking. J Clin Exp Invest 2015; 6 (3): 286-290