Wolff-Parkinson-White 증후군 환자의 심근 관류 이상 (Abnormal Perfusion on Myocardial Perfusion SPECT in Patients with Wolff-Parkinson-White Syndrome) |
Author |
강도영1.차광수2.한승호2.박태호2.김무현2.김영대2, |
Do-Young Kang, M.D.1, Kwang-Soo Cha, M.D.2, Seung-Ho Han, M.D.2, Tae-Ho Park, M.D.2, Moo-Hyun Kim, M.D.2, Young-Dae Kim, M.D.2 |
Affiliation |
동아대학교 의과대학 핵의학교실1, 내과학교실2 Departments of Nuclear Medicine1 and Internal Medicine2, Dong-A University College of Medicine, Busan, Korea |
Abstract |
Purpose: Abnormal myocardial perfusion may be caused by ventricular preexcitation, but its location, extent,
severity and correlation with accessory pathway (AP) are not established. We evaluated perfusion patterns on
myocardial perfusion SPECT and location of AP in patients with WPW (Wolff-Parkinson-White) syndrome.
Materials and Methods: Adenosine Tc-99m MIBI or Tl-201 myocardial perfusion SPECT was performed in 11
patients with WPW syndrome. Perfusion defects (PD) were compared to AP location based on ECG with
Fitzpatrick's algorithm or electrophysiologic study and radiofrequency catheter ablation. Results: Patients had
atypical chest discomfort or no symptom. Risk of coronary artery disease (CAD) was below 0.1 in 11 patients
using the nomogram to estimate the probability of CAD. Coronary angiography was performed in 4 patients
(mid-LAD 50% in one, normal in others). In 4 patients, AP localization was done by electrophysiologic study and
radiofrequency catheter ablation (RFCA). Small to large extent (11.0¡¾8.5%, range:3~35%) and mild to moderate
severity (-71¡¾42.7%, range:-217~-39%) of reversible (n=9) or fixed (n=1) perfusion defects were noted. One
patient with right free wall (right lateral) AP showed normal. PD locations were variable following the location of
AP. One patient with left lateral wall AP was followed 6 weeks after RFCA and showed significantly decreased PD
on SPECT with successful ablation. Conclusion: Myocardial perfusion defect showed variable extent, severity and
location in patients with WPW syndrome. Abnormal perfusion defect showed in most of all patients, but it did
not seem to be correlated specifically with location of accessory pathway and coronary artery disease. Therefore
myocardial perfusion SPECT should be interpreted carefully in patients with WPW syndrome.(Korean J Nucl Med
39(1):9-14, 2005) |
Keyword |
WPW syndrome; myocardial perfusion SPECT; accessory pathway |
Full text Article |
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