Diagnostic Efficacy of Cardiac Scintigraphy with [sup.99m]Tc-Pyrophosphate for Latent Myocardial Inflammation in Patients with Atrial Fibrillation

• Published in: Cardiology research and practice 2020-03
• Main Authors: Ilyushenkova, Julia, Sazonova, Svetlana, Zavadovsky, Konstantin, Batalov, Roman, Rogovskaya, Yuliya, Anfinogenova, Yana, Lishmanov, Yurii
• Format: Article
• Language: English
• Subjects: Atrial fibrillation; Cardiac patients; Care and treatment; Comparative analysis; CT imaging; Diagnosis; Heart; Inflammation; Medical research; Medicine, Experimental; Phosphates
• ISSN: 2090-0597
• DOI: 10.1155/2020/5983751

Objectives. This work aimed to study the efficacy of hybrid [sup.99m]Tc-Pyrophosphate SPECT/CT for diagnosis of latent inflammatory processes in the myocardium of patients with atrial fibrillation (AF). Methods. The study comprised 34 patients aged 44 [+ or -] 9 years with AF of unknown etiology referred for radiofrequency ablation. The data were acquired using hybrid [sup.99m]Tc-Pyrophosphate SPECT/CT. To evaluate and interpret the results of hybrid study and to determine localization of radiopharmaceutical accumulation, scintigraphic and CT images were fused. SPECT/CT results were compared with data of endomyocardial biopsy. Results. Sensitivity, specificity, and accuracy of [sup.99m]Tc-Pyrophosphate SPECT/CT in diagnosing myocarditis were 91%, 100%, and 94%, respectively. Proposed diagnostic criteria for myocarditis comprised intensity of the radiopharmaceutical accumulation in the myocardium and the ratios of focus/lung, focus/vertebral column, and focus/LV pool. Minimum cutoff values for the histologically verified myocarditis were >1.47 for focus/lung index, >0.11 for focus/vertebral column ratio, and >1.26 for focus/lung index. Conclusions. SPECT/CT-based quantitative assessment of [sup.99m]Tc-Pyrophosphate accumulation in the myocardium is a highly informative noninvasive method for diagnosis of inflammatory process in the heart in patients with AF of undefined etiology.