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open access

Vol 25, No 2 (2022)
Research paper
Submitted: 2022-02-01
Accepted: 2022-06-22
Published online: 2022-07-20
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Myocardial perfusion imaging single photon emission computed tomography may detect silent myocardial ischemia in patient with epilepsy

Sofia Markoula1, Afroditi Tsoumani1, Chainti Antonella Votti2, Maria Beltsiou2, Lampros Lakkas3, Konstantinos Pappas3, Ioannis Iakovou4, Andreas Fotopoulos5, Athanassios P Kyritsis12, Chrissa Sioka25
DOI: 10.5603/NMR.a2022.0023
·
Pubmed: 35929125
·
Nucl. Med. Rev 2022;25(2):105-111.
Affiliations
  1. Department of Neurology, University Hospital of Ioannina, Greece
  2. Neurosurgical Institute of Ioannina, University Hospital of Ioannina, Greece
  3. Department of Cardiology, University Hospital of Ioannina, Greece
  4. Department of Nuclear Medicine, AHEPA Hospital, Aristotle University, Thessaloniki, Greece
  5. Department of Nuclear Medicine, University Hospital of Ioannina, Greece

open access

Vol 25, No 2 (2022)
Original articles
Submitted: 2022-02-01
Accepted: 2022-06-22
Published online: 2022-07-20

Abstract

Background: The aim of the present study was to compare the myocardial perfusion imaging (MPI) with [99mTc]tetrofosmin stress — rest single-photon emission computer tomography (SPECT) of patients with epilepsy with matched control individuals. Material and methods: All 29 adult epileptic patients were receiving antiepileptic drugs (AEDs) for epilepsy. Thirty-two individuals matched for gender and age consisted of the control group. MPIs SPECT were performed, and myocardial summed scores were obtained during stress (SSS) and rest (SRS) images. Abnormal MPI was considered when SSS was ≥ 4. In addition, the difference (SDS) between SSS and SRS was also assessed, which represents a rate of reversibility after stress. Results: Twenty of 29 (68.97%) patients with epilepsy had abnormal MPI and 14/32 (43.75%) of the controls (p = 0.04). Among males, 18/23 patients and 11/25 controls had abnormal MPI (p = 0.01), with quite a significant difference for mean SSS between male patients and controls (p = 0.002). Furthermore, SDS comparison showed that irreversible abnormalities were more common in patients than in control individuals. A difference of inadequately compensated myocardial ischemia between patients treated with enzyme inducing AEDs and patients treated with valproic acid was also detected. Conclusions: Single-photon emission computer tomography (SPECT) may detect increased risk for coronary artery disease and further cardiovascular events in patients with epilepsy. Our findings favor the conclusion that SPECT could be used for the early identification of cardiovascular comorbidity in epilepsy.

Abstract

Background: The aim of the present study was to compare the myocardial perfusion imaging (MPI) with [99mTc]tetrofosmin stress — rest single-photon emission computer tomography (SPECT) of patients with epilepsy with matched control individuals. Material and methods: All 29 adult epileptic patients were receiving antiepileptic drugs (AEDs) for epilepsy. Thirty-two individuals matched for gender and age consisted of the control group. MPIs SPECT were performed, and myocardial summed scores were obtained during stress (SSS) and rest (SRS) images. Abnormal MPI was considered when SSS was ≥ 4. In addition, the difference (SDS) between SSS and SRS was also assessed, which represents a rate of reversibility after stress. Results: Twenty of 29 (68.97%) patients with epilepsy had abnormal MPI and 14/32 (43.75%) of the controls (p = 0.04). Among males, 18/23 patients and 11/25 controls had abnormal MPI (p = 0.01), with quite a significant difference for mean SSS between male patients and controls (p = 0.002). Furthermore, SDS comparison showed that irreversible abnormalities were more common in patients than in control individuals. A difference of inadequately compensated myocardial ischemia between patients treated with enzyme inducing AEDs and patients treated with valproic acid was also detected. Conclusions: Single-photon emission computer tomography (SPECT) may detect increased risk for coronary artery disease and further cardiovascular events in patients with epilepsy. Our findings favor the conclusion that SPECT could be used for the early identification of cardiovascular comorbidity in epilepsy.

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Keywords

cardiovascular disease; epilepsy; myocardial ischemia; myocardial perfusion imaging; seizures

About this article
Title

Myocardial perfusion imaging single photon emission computed tomography may detect silent myocardial ischemia in patient with epilepsy

Journal

Nuclear Medicine Review

Issue

Vol 25, No 2 (2022)

Article type

Research paper

Pages

105-111

Published online

2022-07-20

Page views

4340

Article views/downloads

384

DOI

10.5603/NMR.a2022.0023

Pubmed

35929125

Bibliographic record

Nucl. Med. Rev 2022;25(2):105-111.

Keywords

cardiovascular disease
epilepsy
myocardial ischemia
myocardial perfusion imaging
seizures

Authors

Sofia Markoula
Afroditi Tsoumani
Chainti Antonella Votti
Maria Beltsiou
Lampros Lakkas
Konstantinos Pappas
Ioannis Iakovou
Andreas Fotopoulos
Athanassios P Kyritsis
Chrissa Sioka

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