| Background:Percutaneous transluminal septal myocardial ablation (PTSMA) is a novel catheter-based procedure for hypertrophic obstructive cardiomyopathy (HOCM). This prospective study evaluated the left ventricular (LV) myocardial perfusion and function of HOCM patients after PTSMA by using rest gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging.Methods:Thirty-five patients (24men and11women; mean age,48±11y) with a diagnosis of HOCM underwent rest gated99mTc-MIBI SPECT imaging4±10days before (baseline) and4.7±1.0days (short-term) after as well as15.5±8.2months (mid-term) after PTSMA. Semi-quantitative and QGS quantitative perfusion and function evaluation were performed in17LV segments.Results:The myocardial perfusion of septum at short-term after PTSMA was significantly reduced compared with baseline in33(94%) patients (P<0.05). The myocardial perfusion in basal septal was significantly higher at mid-term than at short-term after PTSMA (P<0.05), but still lower than baseline (P<0.001). LV ejection fraction (EF) had significantly decreased after PTSMA (P<0.05) but did not differ significantly between short-term and mid-term after PTSMA. The regional wall motion assessed in basal anterior, basal septal and basal inferior after PTSMA had significantly reduced compared with baseline (P<0.05), and the wall thickening of interventricular septum [especially in basal infero-septal and mid-septal] decreased after PTSMA (P<0.05).Conclusion:Rest gated SPECT imaging could be used to assess LV myocardial perfusion and function and to investigate the therapeutic efficacy of PTSMA during the follow-up. Background:Hypertrophic Cardiomyopathy (HCM) is a heterogeneous monogenetic heart disease manifested as left ventricular (LV) hypertrophy in the absence of dilatation of the chamber and any other condition that can cause an abnormality of a similar degree. It is an important cause of arrhythmic sudden death and how to identify patients at high risk of sudden death accurately has been more important. This prospective study assessed the changes of the glucose metabolism in HCM patients, and tried to reveal the relationship between changes of the glucose metabolism and prognosis.Methods:36patients with HCM (28men and8women,41±12years old) were studied cardiac magnetic resonance (CMR) for assessment of DE (delayed enhancement) and left ventricular function, and twice18F-FDG (2-[18F] fluoro-2-deoxy-D-glucose) PET (positron emission tomography), once in the fasting state and once during glucose load state. A semi-quantitative visual interpretation was made using short axis-, horizontal-, and vertical long axis-myocardial tomograms and a5-grade (-1-3) scoring system in a17-segment model and produced the summed metabolism score. The LVEF (left ventricular ejection fraction), LVEDV (left ventricular end-diastolic volume) were quantified.Results:In the fasting state,18F-FDG metabolism indicated that5(14%) patients had no18F-FDG uptake in left ventricle,3(8%) patients had clear imaging in all segments,28(78%) patients had the imaging at certain segments; And in the glucose-loading state,30(83%) patients had clear imaging in all segments,6(17%) patients had the imaging at certain segments. Patients in the DE-positive group (n=24) had lower summed metabolism score than patients in the DE-negative group (n=12) in fasting state, but there was no significant difference in glucose-loading state. According to the changes between the twice F-FDG PET imaging, the patients were divided into2groups, group1included11patients who had the myocardial segments which were scored-1or0in fasting state, but were scored1or2; group2include the other25patients. Patients in group1had greater left ventricular wall thickness (24.6±3.9mm vs.21.3±5.9mm, P<0.05), greater Left ventricular posterior wall thickness (98.3±29.1mm vs.94.4±16.3mm, P<0.05), more segments with DE [83(44.5%) vs.52(12.2%), P<0.001], and lower LVEF (67.4±15.5%vs.73.1±5.8%, P<0.05).Conclusion:Fasting+glucose loading PET18F-FDG myocardial metabolism imaging can be used to evaluate the diagnosis in HCM patients. Objective:Gated single-photon emission computed tomography (SPECT) myocardial perfusion imaging is useful in assessing left ventricular (LV) myocardial perfusion and function. This study evaluated the prevalence of LV dysfunction after adenosine stress in relation to reversible perfusion defects and angiographic coronary artery disease (CAD).Methods:The study population consisted of70patients who underwent adenosine-mediated stress and rest SPECT. All patients underwent coronary angiography. A semi-quantitative visual interpretation was made using short axis-, horizontal-, and vertical long axis-myocardial tomograms and a5-grade (0-4) scoring system in a17-segment model. Semi-quantified assessment of perfusion was analyzed and produced the summed rest score (SRS), the summed stress score (SSS), and the summed difference score (SDS). The LV function parameters (ejection fraction [EF], end-diastolic volume [EDV], end-systolic volume [ESV]) were quantified by quantitative gated SPECT.Results:Patients were divided into two groups:group1comprised16patients with worsening of LVEF (LVEFrest—LVEFado≥5%), whereas group2comprised the other54patients. Compared with group2, group1had a significantly higher SSS and SDS (9.1±6.8vs.5.6±4.5and6.6±3.8vs.3.6±4.0, respectively; p<0.05), and the severity of coronary artery stenosis was more serious (p<0.05).Conclusion:Worsening of LVEF after adenosine-induced vasodilator stress, as shown by99mTc-MIBI gated SPECT, is a valuable non-perfusion marker of significant CAD and is a prognostic indicator.
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