Adenosine Thallium-201 Myocardial Perfusion Scintigraphy in Acute Congestive Heart Failure with Preserved Left Ventricular Ejection Fraction

Adenosine stress thallium-201 myocardial perfusion imaging(ADTL) is widespreadly available, but the feature of ADTL for heart failure(HF) with preserved left ventricular ejection fraction(HFpEF), early after acute events has not been described. Total 65 pulmonary congestive HF patients were enrolled and they underwent ADTL on 14 ± 7 hospital day. Adenosine stress(stress) and delayed scans both including planar and ECG gated SPECT were carried out. Study patients were divided into 2 groups, 20 patients with stress LVEF 50% or more(preserved group; P-G) and 45 patients less than 50%(reduced group; R-G). Both groups had similarly inverse relationship between stress LVEF and polar map analysis estimated stress extent score(P-G; r = −0.31 and RG; r = −0.33). P-G had significantly lower stress extent score than that of R-G(7.90 ± 11.2 vs 17.9 ± 16.2, P = .013) and had relatively(P = .1) lower stress lung to mediastimun ratio(stress L/M) compared with of R-G(1.30 ± 0.25 vs 1.51 ± 0.54). In R-G, stress L/M and stress LVEF had inverse relation(r = −0.29), but no such relationship were shown in P-G. On the contrary, stress L/M of P-G correlated with echocardiographic LVEF on admission(r = 0.31). These data suggest that ADTL demonstrates ischaemic myocardium, simultaneously reveals HFpEF specific lung thallium distribution after adenosine stress.