INVESTIGATION OF LEFT-VENTRICULAR MYOCARD IAL PERFUSION BY SINGLE-PHOTON-EMISSION COMPUTER-TOMOGRAPHY IN PATIENTS WITH AORTIC-VALVE DISEASE

To determine resting myocardial perfusion in 30 patients with aortic v alve disease (AVD) TI-201 emission computer tomography (ECT) studies a nd heart catheterization were performed. 16 patients had a predominant aortic regurgitation (AR); an aortic stenosis (AS) was found in 14 pa tients at catheterization. Perfusion defects were documented in 10 of 16 patients with AR, and in 5 of 14 patients with AS. Regional determi nation demonstrated in 10 of these 15 abnormal cases at least one of t he perfusion defects in the postero-basal segment. In patients with ao rtic valve disease and normal myocardial perfusion scintigraphy, the e jection fraction (EF) was significantly higher (p < 0.05) as compared to the patients with abnormal TI-201 ECT(EF 65.2 +/- 15.0 % vs. 58.9 /- 15.1 %). Additionally, in the 15 patients with abnormal TI-201 ECT the left ventricular end-diastolic volume index (LVEDVI) and the left ventricular end-systolic volume index (LVESVI) were both increased (LV EDVI in AVD: 130.3 +/- 15.3 ml/m(2) vs. 107.4 +/- 13.6 ml/m(2), LVESVI in AVD: 61.9 +/- 14.6 ml/m(2) vs. 48.0 +/- 9.8 ml/m(2)). In conclusio n, left ventricular perfusion defects at rest can be detected by TI-20 1 ECT in many patients with aortic valve disease. Such myocardial perf usion defects indicate left ventricular enlargement and impaired left ventricular function, especially in patients with aortic regurgitation .