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Right Ventricle Myocardial Perfusion Scintigraphy: Feasibility and Expected Values in Children

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Abstract

Stress myocardial perfusion scintigraphy imaging (SMPSI) has important applications for evaluating coronary disease and ventricular function. Studies consistently focus on the left ventricle (LV), with no normal right ventricle (RV) data available. This study sought to evaluate the feasibility of RV perfusion with technetium (Tc-99m) sestamibi using a low radiotracer dose for children free of coronary artery (CA) anomalies and to determine its normal pattern. Patients with a history of Kawasaki disease who showed no coronary complications on selective angiography or no LV perfusion defects on SMPSI were studied at rest and during an exercise challenge. The RV uptake counts were compared with those for different segments of the LV, and multiple ratios of the uptakes between RV and LV segments were calculated. The study subjects were 23 children (age, 11.1 ± 3.3 years) imaged with 0.12 ± 0.03 mCi/kg at rest and 0.31 ± 0.06 mCi/kg during stress. The RV to LV uptake proportion was approximately 6%. Exercise-related uptake increased threefold in both the RV and the LV. The findings showed RV myocardial scintigraphy to be feasible with reproducible ratios. Potential clinical applications include acquired and congenital CA anomalies such as Kawasaki disease, right CA ostium stenosis after a switch operation, and anomalous origin of the right CA.

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Acknowledgments

This study was a site-specific subanalysis from a large multinational industry-sponsored study. Dr. Velasco-Sanchez is supported by two unrestricted grants provided by the LaCaixa Foundation, Spain, and the Sainte-Justine Hospital Foundation, Montreal, Canada.

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Authors and Affiliations

  1. Division of Pediatric Cardiology, Department of Pediatrics, CHU Sainte-Justine Hospital, Université de Montréal, Montreal, 3175 Cote Sainte-Catherine, Montreal, QC, H3T 1C5, Canada

    Daniel Velasco-Sanchez, Anne Fournier & Nagib Dahdah

  2. Division of Nuclear Imaging, CHU Sainte-Justine Hospital, Université de Montréal, 3175 Cote Sainte-Catherine, Montreal, QC, H3T 1C5, Canada

    Raymond Lambert, Sophie Turpin & Serge Laforge

  3. Department of Radiology, CHU Sainte-Justine Hospital, Université de Montréal, 3175 Cote Sainte-Catherine, Montreal, QC, H3T 1C5, Canada

    Chantale Lapierre

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  1. Daniel Velasco-Sanchez
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  2. Raymond Lambert
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  3. Sophie Turpin
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  4. Serge Laforge
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  7. Nagib Dahdah
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Correspondence to Nagib Dahdah.

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Velasco-Sanchez, D., Lambert, R., Turpin, S. et al. Right Ventricle Myocardial Perfusion Scintigraphy: Feasibility and Expected Values in Children. Pediatr Cardiol 33, 295–301 (2012). https://doi.org/10.1007/s00246-011-0128-0

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  • DOI: https://doi.org/10.1007/s00246-011-0128-0

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