ABSENCE OF DEFECTS IN SPECT TL-201 MYOCARDIAL IMAGES IN PATIENTS WITHSYSTEMIC HYPERTENSION AND LEFT-VENTRICULAR HYPERTROPHY

Hypertension is common in patients undergoing stress and delayed singl e-photon emission computed tomography (SPECT) thallium-201 myocardial perfusion imaging. Investigators have reported that patients with end- stage renal disease and left ventricular hypertrophy due to hypertensi on have diminished lateral/septal count ratios on stress and delayed i maging mimicking lateral myocardial infarction in approxi mately 35% o f patients. Subsequently, hypertension has been cited as a frequent ca use of thallium-201 artifacts. the purpose of this study was to compar e myocardial SPECT thallium-201 distribution in a broader group of pat ients with left ventricular hypertrophy resulting from hypertension wi th normal file subjects in order to determine the prevalence of abnorm al studies and to compare the lateral/septal count ratio. Average coun ts in all myocardial regions in the male study group (n = 16) were com pared with those in the normal male file patients (p = 49), with parti cular attention to the lateral and septal walls. In the group of 16 me n with hypertension and left ventricular hypertrophy, as a whole, the mean lateral/septal wall count ratio was 4.4% lower (1.09+/-0.07) than that in the normal file (1.14+/-0.07; p <0.01). At 3-hour delay, the ratio was virtually the same in the study group (1.06+/-0.09) as in th e normal file (1.06+/-0.06; p = NS). Most Important, for clinical purp oses no patient had a defect, defined as a lateral/septal count ratio >2.0 SD below normal limits. All thallium-201 studies were interpreted as normal. In conclusion, myocardial thallium-201 distribution is nor mal in patients with left ventricular hypertrophy due to hypertension.