The role of technetium-99m sestamibi myocardial perfusion single-photon emission computed tomography (SPECT) in the detection of cardiovascular involvement in systemic lupus erythematosus patients with non-specific chest complaints

Objectives. Systemic lupus erythematosus (SLE) can affect multiple organs. Coronary artery disease has received increasing recognition as a major caus e of morbidity and mortality in SLE in recent years. The purpose of this st udy was to evaluate the utility of technetium-99m sestamibi single-photon e mission computed tomography (Tc-99m-sestamibi SPECT) in the detection of ca rdiovascular involvement in SLE patients with non-specific clinical chest s ymptoms such as chest discomfort and/or dyspnoea and,or occasional palpitat ion. Methods. Thirty-three SLE female patients (age range: 22-45 yr) with non-sp ecific complaints such as chest discomfort and/or dyspnoea and/or occasiona l palpitation were investigated using a Tc-99m-sestamibi myocardial perfusi on SPECT scan at rest and after dipyridamole infusion in a stress study. Th e age- and sex-matched healthy group (24 cases) and SLE patients without an y cardiovascular symptoms/signs (28 cases) were also included as controls i n this study. The results of the uptake pattern of Tc-99m-sestamibi were cl assified into four types including normal, persistent perfusion defect, rev ersible perfusion defect and reverse redistribution. Results. Perfusion abnormalities were detected in 27 cases (seven patients had persistent perfusion defects, 15 patients had reversible perfusion defe cts, one patient had both persistent and reversible perfusion defects, two patients showed a reverse redistribution pattern and two patients had both reversible perfusion defects and a reverse redistribution pattern). The res ults of the SPECT in the healthy group were all normal, However, perfusion abnormalities were detected in 12 cases in the group of asymptomatic SLE pa tients. Conclusions. Tc-99m-sestamibi myocardial perfusion SPECT is a useful non-in vasive imaging modality to detect cardiovascular involvement in SLE patient s with non-specific clinical complaints of heart disease.