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Relationship Between Exercise-Induced Myocardial Ischemia and Reduced Left Ventricular Distensibility in Patients with Nonobstructive Hypertrophic Cardiomyopathy

Satoshi Isobe, MD, PhD1, Hideo Izawa, MD, PhD1, Yasushi Takeichi, MD, PhD1, Makoto Nonokawa, MD, PhD1, Mamoru Nanasato, MD, PhD1, Akitada Ando, MD, PhD1, Katsuhiko Kato, MD, PhD2, Mitsuru Ikeda, MD, PhD3, Toyoaki Murohara, MD, PhD1 and Mitsuhiro Yokota, MD, PhD4

1 Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
2 Department of Radiology, Nagoya University Hospital, Nagoya, Aichi, Japan
3 Department of Medical Information and Medical Records, Nagoya University Hospital, Nagoya, Aichi, Japan
4 Department of Clinical Pathophysiology, Cardiovascular Division, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan



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  		FIGURE 1. Schema of LV 20-segment model as described by Berman et al (25). We defined 7 myocardial segments as follows: segment numbers 1, 7, and 13 as anterior wall; segment numbers 2, 8, and 14 as anteroseptal wall; segment numbers 3, 9, and 15 as inferoseptal wall; segment numbers 4, 10, and 16 as inferior wall; segment numbers 5, 11, and 17 as posterolateral wall; segment numbers 6, 12, and 18 as anterolateral wall; and segment numbers 19 and 20 as apical wall.

 


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  		FIGURE 2. Stress-redistribution 201Tl SPECT of 45-y-old man from ischemic group. Redistribution (RD) was observed in anteroseptal, inferoseptal, inferior, and posterolateral walls on short-axis and vertical long-axis images (arrows).

 


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  		FIGURE 3. Stress-redistribution 201Tl SPECT and 18F-FDG PET in 1 ischemic group patient. Anteroseptal wall with redistribution on 201Tl SPECT (black arrows) showed increased uptake on 18F-FDG PET (pink arrow).

 




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