Berrin UMMAN, Yasemin ŞANLI, Sema CANTEZ, Hüseyin OFLAZ, Cüneyt TÜRKMEN, Handan TOKMAK, Ayşe MUDUN

Normal koroner anjiografisi bulunan hastalarda miyokard perfüzyon spect'te izlenen defekt lokalizasyonları ile koroner arter hastalığı için risk faktörleri arasındaki ilişki

Amaç: Bu çalışmanın amacı, miyokard perfüzyon SPECT'te iskemik perfüzyon defekti olan, koroner anjiografisi normal bulunan kişilerde, koroner arter hastalığı için prediktif risk faktörlerinin dağılımı ve risk faktörleri ile perfüzyon defektlerinin lokalizasyonları arasındaki ilişkinin araştırılmasıdır. Gereç ve yöntem: Miyokard perfüzyon SPECT'te iskemi düşündüren perfüzyon defekti olan ve sintigrafiden sonra en fazla üç ay içerisinde yapılan koroner anjiografileri normal bulunan toplam 69 hasta (47 kadın, 22 erkek; ortalama yaş: 53±10 yıl) retrospektif olarak incelendi. Ellibeş (%80) hastaya yürüme bandında egzersiz, 14 (%20) hastaya farmakolojik stres testi yapıldı. Görüntülemede tek gün stres/rest protokolü uygulandı. Çalışmada istatistik yöntemi olarak Fisher's exact test ve ki-kare testleri kullanıldı. Bulgular: Hastaların 44'ünde hipertansiyon, 32'sinde hiperlipidemi, 12'sinde diabet öyküsü vardı. Efor testi hastaların 19'unda (%27,5) pozitif olarak bulundu. Cinsiyet ile koroner arterlerden sağ koroner arter (RCA), hipertansiyon ile ise sirkumfleks (Cx) alanı arasındaki ilişki istatistiksel olarak anlamlı bulundu (p

The relationship between the localization of myocardial perfusion defects and risk factors for coronary artery disease in patients with normal coronary angiography

Objective: The aim of this study was to investigate the relationship between the risk factors for systemic vascular diseases and the localization of the perfusion defects in patients having ischemic perfusion defects in myocardial SPECT with normal coronal angiography. Materials and methods: In this retrospective study, a total of 69 (47 female, 22 male, mean age 53±10 years) patients with ischemic perfusion defect in myocardial SPECT with normal coronal angiography in three months after the myocardial SPECT were enrolled. Of these patients; 55 (80%) and 14 (20%) had treadmill exercise and pharmacological stress tests, respectively. Imaging of these patients was performed with single day stress and rest protocol. Fisher's exact test and Chi-square tests were used for statistical analysis. Results: Risk factors for systemic vascular diseases were as follows: hypertension in 44, hyperlipidemia in 32, diabetes in 12 patients. Effort test was found to be positive in 19 (29.7%) of the patients. Gender was significantly associated with occlusion of the right coronary artery, while hypertension was significantly associated with the occlusion of the circumflex artery. Among predictive risk factors, patients with hypertension had more lateral wall perfusion defects compared with the patients with other risk factors. In addition, anterior perfusion defects were more encountered in female patients, while inferior perfusion defects were more detected in male patients. Conclusion: Breast attenuation in women and diaphragm attenuation in men and lateral wall perfusion defects in hypertensive patients with normal coronary angiography having myocardial perfusion defects may lead to false positive interpretations.

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