The reverse redistribution phenomenon RR on 201 Tl SPECT has been focused mainly on ischemic improvement regions after reperfusion therapy or vasospastic angina pectoris. However, RR analysis has not been used in the context of non-ischemic disease. The aim of this study was to evaluate the clinical role of RR on 201 Tl SPECT in patients without a history of myocardial ischemia. We retrospectively enrolled 86 patients showing RR by myocardial perfusion SPECT and studied 75 other patients as a

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... ntrol group. For quantitative analysis, each 201 Tl SPECT polar map was divided into 13 segments. Differences between the RR and control group were assessed with respect to patient characteristics and cardiac event-free survival using the Kaplan-Meier method. RR was detected frequently in the inferoposterior wall, septal portion of the anterior wall, and septum. The two groups showed signi cant differences in rates of heart failure P 0.01 , hypertrophic cardiomyopathy P 0.05 , and wall motion abnormality P 0.05 , but not in the rate of event occurrence. The study demonstrated that RR on 201 Tl SPECT could indicate the existence of myocardial damage ; however, it would not be a factor that determines the prognosis.