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

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.

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

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.

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