Title:Assessing Myocardial Involvement in Systemic Lupus Erythematosus Patients
without Cardiovascular Symptoms by Technetium-99m-sestamibi
Myocardial Perfusion Imaging: A Correlation Study on NT-proBNP
Volume: 19
Author(s): Kejing Shao, Fenghong Yuan, Fei Chen, Jianfeng Wang, Xiaoliang Shao, Feifei Zhang, Bao Zhu and Yuetao Wang*
Affiliation:
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
- Changzhou Key Laboratory of Molecular Imaging, Changzhou, China
Keywords:
Systemic lupus erythematosus, cardiac involvement, gated myocardial perfusion imaging, 99mTc-MIBI, NTproBNP, myocardial involvement.
Abstract:
Background: In patients with systemic lupus erythematosus (SLE), myocardial involvement
is the third leading course of death after lupus nephropathy (LN) and infections. Previous autopsy studies
have demonstrated a high incidence of cardiovascular abnormalities in the myocardium. However,
the patients with typical symptoms are far much fewer than expected from post-mortem examinations.
Objectives: The current study aimed to evaluate the technetium-99m-sestamibi (99mTc-MIBI) gated
myocardial perfusion imaging (GMPI) characteristics of lupus patients without cardiovascular symptoms,
and the relationships between GMPI characteristics and biochemical markers of myocardial injury,
and to explore the role of GMPI in assessing myocardial involvement.
Methods: Thirty patients were studied with rest myocardial perfusion imaging, and summed rest score
(SRS), summed motion score (SMS), and summed thickening score (STS) were calculated automatically.
Biomarkers, including N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and
creatine-kinase-MB (CK-MB), were detected simultaneously. GMPI parameters, LV functions and
biomarkers were compared between two NT-proBNP groups. The relationships between these parameters
were studied by correlation analysis.
Results: SMS, STS, and glomerular filtration rate (eGFR) were the main influencing factors of NTproBNP
level (p = 0.001, <0.001, 0.042, respectively). Thirteen patients with an evaluated concentration
of NT-proBNP had the lower left ventricular ejection fraction (LVEF), peak filling rate (PFR),
eGFR and higher levels of CK-MB (in all comparisons, p < 0.05), and SRS was the only influencing
factor of NT-proBNP (p = 0.007). Within thirteen patients with SRS≥2, there was a significant correlation
between SRS and NT-proBNP (p < 0.001).
Conclusion: 99mTc-MIBI GMPI could evaluate the left ventricular function and prompt the cardiomyocyte
function at the cellular level. SMS and STS were the main influencers for plasma NT-proBNP,
and SRS was the independent factor for elevated NT-proBNP. This radionuclide imaging method
could provide additional diagnostic information on myocardial involvement in patients with SLE.
