Journals / Ege Tıp Dergisi / 2010 / Cilt: 49 - Sayı: 3

Tipik göğüs ağrısına karşın koroner arterleri normal olan olgularda Tc-99m MIBI myokard perfüzyon sintigrafisi bulguları

Tc-99m MIBI myocard perfusion SPECT findings in patients with typical chest pain and normal coronary arteries

Pages
169–176
DOI
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We conclude that the presence of perfusion defects on MPS is a significant objective indicator in patients with cardiac syndrome X.

📌 3 Key Takeaways

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Objective & Hypothesis:Aim: The aim of this study was to determine the regional distribution of myocardial perfusion abnormalities and defect size using Tc-99m MIBI myocardial perfusion scintigraphy (MPS) in patients with anginal chest pain, positive exercise test and angiographically normal coronary arteries.
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Key Findings & Data:Material and Methods: Eighty-one (81) patients (40 male, 41 female) who have angina pectoris, positive stress ECG and normal coronary angiography were included this study.
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Conclusion & Impact:We conclude that the presence of perfusion defects on MPS is a significant objective indicator in patients with cardiac syndrome X.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Aim: The aim of this study was to determine the regional distribution of myocardial perfusion abnormalities and defect size using Tc-99m MIBI myocardial perfusion scintigraphy (MPS) in patients with anginal chest pain, positive exercise test and angiographically normal coronary arteries. Material and Methods: Eighty-one (81) patients (40 male, 41 female) who have angina pectoris, positive stress ECG and normal coronary angiography were included this study. Clinical data of these patients who underwent Tc-99m MIBI MPS were retrospectively reviewed. For MPS imaging, the two-day stress-rest Tc-99m MIBI protocol was used. SPECT data were evaluated both visually and semi-quantitatively. The number of abnormal segments was defined as the defect number (DN). Results: There were 65 (80.3%) patients with abnormal MPS and all of these perfusion abnormalities were reversible defects. Frequency of smoking, hyperlipidemia and diabetes mellitus was significantly higher in patients with abnormal MPS than normal MPS. The proportion of postmenopausal women was also higher in the MPS positive group. Most of the myocardial perfusion defects were seen on the nferior wall in both male and female patients on MPS images. The difference between the mean values of DN in the diabetic and nondiabetic groups was statistically significant (5.66±3.14 and 4.51±2.90 respectively. p=0.041). Conclusion: A high prevalence of myocardial perfusion defects was observed in our patients with syndrome X. All of these perfusion abnormalities were reversible. We conclude that the presence of perfusion defects on MPS is a significant objective indicator in patients with cardiac syndrome X.

Özet

Amaç: Bu çalışmada anjinal göğüs ağrısı olan, eforlu EKG testi pozitif ve koroner anjiyografide anlamlı stenoz saptanmayan olgularda myokard perfüzyon sintigrafisi bulgularını değerlendirmek amaçlandı. Yöntem ve Gereç: Göğüs ağrısı olan, eforlu EKG'si pozitif ve koroner anjiyografisi normal 81 (41 kadın, 40 erkek) olguya ait Tc-99m MIBI myokard perfüzyon sintigrafisi (MPS) bulguları retrospektif olarak incelendi. Tüm olguların eforlu EKG, ekokardiyografi ve anjiyografisi mevcuttu. MPS vizüel ve semikantitatif yöntemle incelendi. MPS bulguları ile olguların klinik özellikleri ve diğer kardiyolojik test sonuçları arasındaki arasındaki korelasyon değerlendirildi. Bulgular: Atmışbeş olguda (% 80.3) MPS'de reversibl perfüzyon defektleri saptandı. Olguların hiçbirinde fiks perfüzyon defekti gözlenmedi. Hiperlipidemi, sigara kullanımı, diabetes mellitus sıklığı ve postmenapozsal dönemdeki kadın oranı MPS'de perfüzyon defekti saptanan olgularda normal olanlardan daha yüksekti. Semikantitatif incelemede MPS'de 81 hastada toplam 1620 segmentten 401'inde (% 24.8) perfüzyon defekti izlendi. Her iki cinstede en sık inferior duvarda perfüzyon anomalisi gözlendi. Diabetik olgularda defekt sayısının anlamlı biçimde daha yüksek olduğu dikkat çekti (sırasıyla; 5.66±3.14 ve 4.51±2.90, p=0.041). Sonuç: Sendrom X'li olgularda MPS ile saptanan myokardiyal perfüzyon defekti sıklığının yüksek ve bu perfüzyon anomalilerinin tümünün iskemi ile uyumlu karakterde olduğu saptandı. Kardiyak sendrom X'li olgularda MPS'nin perfüzyon anomalilerinin varlığını değerlendirmede önemli bir objektif gösterge olduğu sonucuna varıldı.

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Cite This Article

ÖMÜR, Ö., BURAK, Z., SAĞCAN, A. (2010). Tipik göğüs ağrısına karşın koroner arterleri normal olan olgularda Tc-99m MIBI myokard perfüzyon sintigrafisi bulguları. Ege Tıp Dergisi, Cilt: 49 - Sayı: 3, 169–176. https://ajindex.com/articles/222848

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References (14)

  1. Kemp HG Jr. Left ventricular function in patients with anginal syndrome with normal coronary arteriograms. Am J Cardiol 1973; 32: 375-376
  2. Montorsi P, Fabbiocchi F, Loaldi A, et al. Coronary adrenergic hyperreactivity in patients with syndrome X and abnormal electrocardiogram at rest. Am J Cardiol 1991; 68: 1698-1703
  3. Rosano GMC, Ponikowski P, Adamopoulos S, et al. Abnormal autonomic control of the cardiovascular system in syndrome X. Am J Cardiol 1994; 73: 1174-1179
  4. Quyyumi AA, Cannon RO, Panza JA, Diodati JG, Epstain SA. Endothelial dysfunction in patients with chest pain and normal coronary arteries. Circulation 1992; 86: 1864-1871
  5. Shirashi A, Ikeda H, Haramaki N, et al. Abnormal myocardial blood flow distribution in patients with angina pectoris and normal coronary arteriograms. Jpn Circ J 2000; 64: 566-571
  6. Kaski JC, Aldama G, Cosin-Sales J. Cardiac syndrome X. Diagnosis, pathogenesis and management. Am J Cardiovasc Drugs 2004; 4: 179-194
  7. Cavuşoğlu Y, Entok E, Timuralp B et al. Regional distribution and extent of perfusion abnormalities, and lung to heart uptake ratios during exercise thallium-201 SPECT imaging in patients with cardiac syndrome X. Can J Cardiol 2005; 21: 57-62
  8. Hsu HB, Shiau YC, Kao A et al. Technetium-99m tetrofosmin myocardial perfusion single photon emission computed tomography in syndrome X. A preliminary report. Jpn Heart J 2003; 44: 153-162
  9. Sun SS, Huang JL, Tsai SC, Ho YJ, Kao CH. The higher likelihood of developing cardiomegaly during follow-up in patients with syndrome X and abnormal thalium-201 myocardial perfusion SPECT. Int J Cardiovasc Imaging 2001; 17: 271-278
  10. Kao CH, Wang SJ, Ting CT, Chen YT. Tc-99m sestamibi myocardial SPECT in syndrome X. Clin Nucl Med 1996; 21: 280-283
  11. Sullivan AK, Holdright DR, Wright CA, et al. Characterisation and follow-up of patients with chest pain and normal coronary arteries. J Am Coll Cardiol 1993; 121: 317A
  12. Fujita H, Yamabe H, Yokoyama M. Dipyridamole-induced reversible thallium-201 defect in patiens with vasospastic angina and nearly normal coronary arteries. Clin Cardiol 2000; 23: 24-30
  13. Zouridakis EG, Cox ID, Garcia-Moll X at al. Negative stress echocardiographic responses in normotensive and hypertensive patients with angina pectoris, positive exercise stress testing, and normal coronary arteriograms. Heart 2000; 83: 141-146
  14. Lorenzo AD, Lima RSL, Siqueira-Filho AG, Pantoja MR. Prevalence and prognostic value of perfusion defects de