SERIAL EVALUATION OF DILATED CARDIOMYOPATHY WITH EXERCISE TL-201 TOMOGRAPHY - CORRELATION WITH THE EVOLUTION OF LEFT-VENTRICULAR PARAMETERS

The purpose of this prospective study was to correlate (1) the initial findings of exercise thallium-201 tomography with the evolution of le ft ventricular parameters at long term follow-up in patients with dila ted cardiomyopathy and (2) the changes of exercise thallium-201 tomogr aphy repeated 1 year later. We studied 19 men with dilated cardiomyopa thy and normal coronary angiogram. Two patients died and three patient s had heart transplantation during followup. The other 14 patients wer e assessed at baseline and I-year follow-up. Thallium-201 tomograms we re divided into 20 segments for each patient. Two groups were defined according to the evolution of left ventricular ejection fraction: grou p I (n = 7) had unchanged or decreased ejection fraction at follow-up (24 +/- 11% at baseline versus 22 +/- 11% at follow-up, ns) and group 2 (n = 7) had improved ejection fraction at follow-up (25 +/- 9% at ba seline versus 49 +/- 8% at follow-up, P < 0.03). The number of total a bnormal segments at stress were not statistically different at baselin e between groups 1 and 2, and in group I between baseline and follow-u p. Group 2 at follow-up had a reduced number of total abnormal segment s (P < 0.03). The percentage of reversibility was similar in both grou ps at baseline and follow-up. On exercise thallium-201 tomography, nei ther the presence nor the reversibility of stress myocardial perfusion abnormalities can predict improvement of left ventricular ejection fr action in dilated cardiomyopathy. However, regression of dilated cardi omyopathy is accompanied by a reduction of stress myocardial perfusion abnormalities.