SIGNIFICANCE OF CALCIFIC VALVULAR HEART-DISEASE IN TC-99M PYROPHOSPHATE MYOCARDIAL-INFARCTION SCANNING - RADIOGRAPHIC, SCINTIGRAPHIC, AND PATHOLOGICAL CORRELATION

  • 1 January 1977
    • journal article
    • research article
    • Vol. 18  (8) , 776-780
Abstract
99mTc PPi is currently considered the best scanning agent for the diagnosis of acute myocardial infarction. False-positive scans were reported in association with unstable angina, alcoholic cardiomyopathy and ventricular aneurysms. Of the patients, 86% (12/14) with either calcific aortic or mitral valvular heart disease had positive PPi cardiac scintiscans and the location of the PPi uptake was limited to the calcific valve in all (9/9) of the patients who underwent valve replacement surgery. Six patients with valvular disease without radiologic evidence of Ca had negative PPi heart images. Three of these patients had surgical valve replacement, and in none was there increased uptake in the resected valve. Of the patients with calcified aortic valves, 75% had localization of the PPi activity to the area of the aortic valve, whereas 50% of the patients with calcified mitral valves showed a diffuse pattern of uptake on the cardiac image. In vitro demonstration of increased radioactivity in surgically removed cardiac valves warrants the conclusion that 99mTc PPi is taken up by calcified heart valves. While PPi heart scanning is a sensitive indicator of acute myocardial infarction, false-positive scans can occur in the presence of calcific valvular disease, due to localization of PPi in the calcified portion of the valve.

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