Implications of abnormal myocardial perfusion and normal angiography in patints with associated risk factors for coronary disease

ABSTRACT

Comparison between coronary angiography (CA) and SPECT myocardial perfusion scintigraphy (MPS) using Tc-99m labeled compounds in 30 patients (23 males, 7 females) yielded a sensitivity of 97 percent and a specificity of 76 percent for lesion detectability (p<0.01) using CA as the reference standard. Angiographic analysis initially ascribed the scintigraphic defects in 8 patients (5 males, 3 females) as falsely positive. Eleven coronary artery territories were involved eight within the LAD and three within the RCA. Patient symptomatology however, prompted angiographic review which revealed myocardial bridging of the LAD in one male patient and differential perfusion of the LAD in two male patients. A review of the patients' history revealed associated risk factors such as diabetes, hyperlipidaemia, hypertension and smoking. Based on these findings, critical re-evaluation of other pathophysiolocial abnormalities in the absence of vascular stenosis should thus be sought in patients with positives MPD and associated risk factors to avoid unsuspected patient morbidity (AU)