Relevancia de la hipocinesia septal como hallazgo en la gated-SPECT de perfusión miocárdica

Abstract

ObjectiveTo identify septal hypokinesia (SH) with signs of right ventricular (RV) overload. Materials and methodsProspective study of consecutive patients divided into cases with SH (n=39) and controls without SH (n=27). Subjects with septal perfusion defects and alterations in conduction were excluded. Images were obtained after injection of 20 mCi (740 MBq) of technetium tracer. The perfusion and septal mobility, RV and left ventricle values were quantified and other clinical parameters were obtained. Multivariate non-parametric tests and Pearson's correlation tests were applied. ResultsRV perfusion was higher in the case group (31.7% vs 27.5 %, p=0.012). 35.9 % of cases had undergone cardiac surgery (CS) in the past. A higher number of subjects with valve diseases (VD) was found in the case group (23.1 % vs 3.7 %, p=0.031); the same occurred with smoking (46.2 % in cases vs. 11.1% in controls, p=0.05). Correlation was obtained between septal mobility and RV perfusion (−0.374, p=0.015 bilateral), and between mobility of the septum and the RV (0.299, p=0.015 unilateral). DiscussionThis test has been scarcely applied in RV pathology; this entity has great repercussion on the prognosis of patients with heart failure. These findings may clarify certain aspects of its physiopathology. ConclusionsAccording to our study, SH is associated with the degree of RV perfusion and mobility, as well as the presence of history of CS, VD and smoking.