P270	Myocardium perfusion and metabolism in patients with dilated cardiomyopathy estimated by single photon emission computerized tomography and positron emission tomography.
I.Sergienko, L.Radkevitch, V.Naumov
Russian Cardiology research center, Moscow, RU.

Aim: Detect myocardial perfusion and metabolism disorders due left bundle-branch block (LBBB) in patients with dilated cardiomyopathy (DCM). Material and methods: Eighteen patients with DCM were included in this study. Six of them were diagnosed as DCM and no myocardial conduction abnormalities (group 1), the other 12 patients with DCM have LBBB (group 2). All of them underwent myocardial 18F-FDG-PET at fasting and after glucose loading and 99m-Tc-MIBI SPECT at the rest. MIBI and FDG uptake was quantified by the ratio of the counts at the interventricular septum (IVS) to those at the LV lateral wall (S/L ratio). Results: The extent of defect perfusion was more in patients of group 2 (p<0.05), there was no difference of severity of defect perfusion by SPECT. The uptake of MIBI in IVS was less in patients group 2 (P<0.001). The S/L ratio in patients group 1 was 0.82±0.14, group 2 - 0.53±0.18 (ð<0.001). By qualitative PET analysis there was significant decreasing of FDG uptake in IVS in group 2. By quantitative analysis in group 1 FDG uptake in IVS was 68±5%, in lateral wall 83±14%; in group 2 - 32±17% and 79±8% correspondingly. The S/L ration was significantly higher in group 1 - 0.80±0.21 by comparison of group 2 - 0.38±0.15 (p<0.001), i.e. the uptake of FDG in IVS was significantly less in patients with LBBB. Conclusion: The uptake as MIBI so FDG in IVS was decreased in both groups. The LBBB presents in patients with DCM produce not only strongly perfusion disorders in IVS, but metabolism disorders the same localization.

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