Diagnostic Efficacy of Cardiac Scintigraphy with 99mTc-Pyrophosphate for Latent Myocardial Inflammation in Patients with Atrial Fibrillation

Julia Ilyushenkova; Svetlana Sazonova; Konstantin Zavadovsky; Roman Batalov; Yuliya Rogovskaya; Yana Anfinogenova; Yurii Lishmanov

doi:10.1155/2020/5983751

Diagnostic Efficacy of Cardiac Scintigraphy with ^99mTc-Pyrophosphate for Latent Myocardial Inflammation in Patients with Atrial Fibrillation

Cardiol Res Pract. 2020 Mar 16:2020:5983751. doi: 10.1155/2020/5983751. eCollection 2020.

Authors

Julia Ilyushenkova¹, Svetlana Sazonova¹, Konstantin Zavadovsky¹, Roman Batalov¹, Yuliya Rogovskaya¹, Yana Anfinogenova¹, Yurii Lishmanov¹

Affiliation

¹ Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, 111a Kievskaya Str., Tomsk 634012, Russia.

Abstract

Objectives: This work aimed to study the efficacy of hybrid ^99mTc-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 ± 9 years with AF of unknown etiology referred for radiofrequency ablation. The data were acquired using hybrid ^99mTc-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 ^99mTc-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 ^99mTc-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.