Single Photon Emission Computed Tomography of Technetium-99m Tetrofosmin Myocardial Perfusion Imaging in Patients with Systemic Lupus Erythematosus

Aim of this Study: Was to evaluate the utility of single photon emission computed tomography (SPECT) of technetium- 99m tetrofosmin (Tc-99m TF) myocardial perfusion imaging to detect myocardial involvement in patients with systemic lupus erythematosus (SLE) and its relation to presence or absence of cardiolipin antibodies (aCL). Patients and Methods: Three groups of subjects-group 1: 33 SLE female patients with non-specific cardiac symptoms and signs, group 2: 28 female SLE patients without any cardiac symptoms and signs, and group 3: 24 female healthy controls were evaluated by comparing rest and dipyridamole-stress Tc-99m TF myocardial perfusion SPECT Cardiolpin antibodies had been assessed in all cases. Results: Tc-99m TF myocardial perfusion SPECT revealed perfusion defects in 82% and 43% of the cases in groups 1 and 2, respectively. However, no cases in group 3 demonstrated myocardial perfusion defects. Multivariate analysis revealed a positive correlation between age and the number of CAD risk factors (r2=0.482). Also, lower HDL, higher incidence of smoking, higher body mass index and postmenopausal status are an important determinant factors for presence of CAD in SLE patients. However, there is statistically higher prevalence of reversible perfusion defects (RDs) in group 2 with (+) aCL (31%) compared to (-) aCL (13.3%) in the same group. Also, RDs were statistically higher in (-) aCL of group 1 (61.1%) compared to ( - ) aCL in group 2. Conclusion: Tc-99m TF myocardial perfusion SPECT is a useful noninvasive imaging modality to detect cardiac involvement in SLE patients with or without cardiac symptoms and signs. Lower HDL cholesterol level, age and postmenopausal status in addition to higher body mass index were the variables associated with myocardial perfusion abnormalities in our patients.