Key result
Dipyridamole stress induces prolonged myocardial stunning and reversible septal hypoperfusion in a child with HCM.
Why the study?
Myocardial ischemia and stunning are important mechanisms in hypertrophic cardiomyopathy, but their demonstration by dipyridamole stress gated myocardial SPECT in children is not well described.
Does dipyridamole stress induce myocardial stunning in a child with hypertrophic cardiomyopathy?
Case Report (n=1)
Does dipyridamole stress induce myocardial stunning in a child with hypertrophic cardiomyopathy?
Dipyridamole stress can induce prolonged myocardial stunning in pediatric patients with hypertrophic cardiomyopathy, as demonstrated by quantitative gated SPECT.
May warrant caution with dipyridamole stress in pediatric HCM; leaves open whether protocols require modification.
PURPOSE: Myocardial ischemia is an important problem in hypertrophic cardiomyopathy. Stunning is an important mechanism in progressive dysfunction of the ischemic myocardium. In this report, the authors found prolonged myocardial stunning in a child with hypertrophic cardiomyopathy that was induced by dipyridamole stress on quantitative gated SPECT. MATERIALS AND METHODS: A 6-year-old boy with septal hypertrophy underwent rest and dipyridamole stress gated myocardial SPECT. Software was used to quantify automatically segmental perfusion and function at rest and after stress. RESULTS: Perfusion imaging showed a reversible perfusion decrease in the hypertrophic septum. Cine-gated imaging of the septum showed dyskinesia and a severe abnormality of systolic thickening during the poststress period, whereas it showed nearly complete recovery at rest. Quantified regional perfusion and function indices also showed this perfusion decrease and myocardial dysfunction after dipyridamole stress. CONCLUSION: In a child with hypertrophic cardiomyopathy, myocardial stunning was induced by dipyridamole stress, in accordance with decreased perfusion reserve.
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Paeng et al. (2002) conducted a case report in Hypertrophic cardiomyopathy (n=1). Dipyridamole stress quantitative gated perfusion SPECT vs. Rest was evaluated on Myocardial stunning and perfusion/function indices. Dipyridamole stress induced prolonged myocardial stunning and a reversible perfusion decrease in the hypertrophic septum of a child with hypertrophic cardiomyopathy.
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