Medical Radiology and Radiation Safety. 2013. Vol. 58. No. 3. P. 39–44
NUCLEAR MEDICINE
Yu. B. Lishmanov, K.V. Zavadovskiy, V.V. Saushkin, S.V. Popov
Scintigraphic Semiotics of Arrhythmogenic Cardiac Dysfunction in Children and Teenagers with Ventricular Extrasystoles
Research Institute for Cardiology of SB RAMS, Tomsk, Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
Abstract
Purpose: To develop the radionuclide semiotics of arrhythmogenic heart dysfunction in children and teenagers with ventricular extra systoles.
Material and methods: The study included 79 children and teenagers (mean age 12.9 ± 3.2 years) with ventricular extra systoles. Intracardiac electrophysiological study followed by radio frequency ablation foci of arrhythmogenic activity was carried out 24 patients. The comparison group included 15 patients of similar age and sex, with the exclusion of cardiac arrhythmias. All patients underwent gated blood pool SPECT. We have calculated the sensitivity, specificity, diagnostic accuracy, positive and negative predictive value. As a reference method we used intracardiac electrophysiological study of the heart. Results: In all patients with ventricular extra systoles we observed the areas of asynchronous contraction – the sign of myocardium mechanical heterogeneity. The most common site of these areas is the right ventricle. When the source of arrhythmia located in the right ventricular outflow tract – preliminary contraction areas are located in the anterior wall of the right ventricle. And when source of arrhythmia located in the left sinus of Valsalva, the asynchrony appears in the interventricular septum. In the group of children and teenagers with ventricular arrhythmia observed a moderate dilatation of the chambers and reduced contractile function of the heart, while this phenomenon is most pronounced for ectopic from the left sinus of Valsalva.
Conclusion: The existence of a zones of asynchronous contraction on the phase-polarity maps in children with ventricular arrhythmia can be considered pathognomonic symptom of the existence of scintigraphic ectopia.
Key words: right ventricle, left ventricle, quantitative blood pool SPECT, dyssynchrony, ventricular extrasystoles