Myocardial injury aggravated by hypothyroidism in patients with idiopathic dilated cardiomyopathy: the evidence based on 99Tcm-MIBI SPECT/18F-FDG PET imaging and cardiac MRI
10.3760/cma.j.issn.2095-2848.2014.03.001
- VernacularTitle:特发性扩张型心肌病合并甲状腺功能减退加重心肌损伤的影像学评价
- Author:
Xinghong MA
;
Lei WANG
;
Wenyao WANG
;
Chaowu YAN
;
Yida TANG
;
Shihua ZHAO
;
Wei FANG
- Publication Type:Journal Article
- Keywords:
Cardiomyopathy,congestive;
Hypothyroidism;
Tomography,emission-computed;
Tomography,X-ray computed;
Magnetic resonance imaging;
MIBI
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2014;34(3):161-165
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the relationship between hypothyroidism and myocardial injury in patients with idiopathic dilated cardiomyopathy (IDC) by 99Tcm-MIBI SPECT/18 F-FDG PET and late-gadolinium enhancement cardiac magnetic resonance imaging (cMRI-LGE).Methods Sixty-three consecutive patients (42 males and 21 females,(52±11) years) with IDC were enrolled from October 2010 to December 2012.Serum TT3,TT4,FT3,FT4 and TSH were determined using a fully automated chemiluminescence immunoassay.All patients underwent 99Tcm-MIBI myocardial perfusion SPECT/18F-FDG myocardial metabolism PET imaging and cMRI-LGE.Seventeen segments model was used for segmental analysis.Patterns of perfusion/metabolism were classified as normal,mismatch,mild-to-moderate match and complete match.cMRI-LGE was classified into 3 categories (non-LGE,mid-wall LGE and transmural LGE).x2 test was used for data analysis.Results All patients were divided into euthyroid group (n =53) and hypothyroidism group (n =10) according to the levels of serum thyroid hormones.The percentage of normal perfusion/metabolism segments in the euthyroid group was apparently higher than that in the hypothyroidism group:71.8％ (647/901) vs 57.6％ (98/170),x2 =13.50,P＜0.001 ; whereas the percentage of perfusion/metabolism mismatch segments in the euthyroid group was significantly lower than that in the hypothyroidism group:17.8％ (160/901) vs 31.2％ (53/170),x2=16.20,P＜0.001.The euthyroid group had a higher percentage of non-LGE segments (88.0％ (793/901) vs 69.4％ (118/170),x2 =35.70,P＜0.001) and a lower percentage of mid-wall LGE segments (4.8 ％ (43/901) vs 24.1％ (41 / 170),x2 =74.70,P＜ 0.001) compared to hypothyroidism group.Conclusions Hypothyroidism has a detrimental effect on myocardium.99Tcm-MIBI SPECT/18F-FDG PET imaging is sensitive in detecting viable/ischemia myocardium,and cMRI-LGE is good at detecting moderate fibrosis.Combining SPECT/PET imaging and cMRI-LGE for assessing myocardial injury would provide more comprehensive information.
