[When can normal stress myocardial perfusion scans be observed in patients with chest pain and known or suspected coronary artery disease?]

Medicina (Kaunas). 2004;40(7):627-32.
[Article in Lithuanian]

Abstract

The aim of this study was to establish characteristic clinical data in patients with normal stress myocardial perfusion scans.

Material and methods: 99mMIBI scintigraphy was performed following a one-day protocol (stress-rest) in 806 patients (out of them 451 men) with suspected or known coronary artery disease. A bicycle exercise test response was estimated as pathological, non-pathological, borderline and non-informative. Myocardial perfusion was scored according to the size and severity of defect.

Results: Myocardial perfusion was normal in 287 (35.6%) patients. Univariate analysis showed, that normal stress myocardial perfusion scans more often were established in women than in men (p=0.00001, odds ratio 8.55), in patients with atypical anginal or non-anginal chest pain than with typical angina (p=0.0001, odds ratio 1.92), in patients without previous myocardial infarction (p=0.0001, odds ratio 3.28) and without myocardial revascularization (p=0.0001, odds ratio 3.28). The characteristic bicycle exercise test data for normal scans were non-pathological response vs pathological (p=0.00001, odds ratio 3.03) and reason of discontinuance - target heart rate achieved (85% of maximum) vs ischemic changes (p=0.0005, odds ratio 2.37).

Conclusions: Normal stress myocardial perfusion scans were more often present in women, in patients with atypical angina or non-anginal chest pain, in patients without myocardial infarction and without myocardial revascularization. Achieved target heart rate and non-pathological response to exercise test were commonly observed in patients with normal perfusion scans.

Publication types

  • Comparative Study

MeSH terms

  • Analysis of Variance
  • Angina Pectoris / diagnostic imaging
  • Angina Pectoris / physiopathology
  • Angioplasty, Balloon, Coronary
  • Chest Pain / diagnostic imaging*
  • Chest Pain / physiopathology
  • Chi-Square Distribution
  • Coronary Circulation*
  • Coronary Disease / diagnostic imaging*
  • Coronary Disease / physiopathology
  • Coronary Disease / surgery
  • Coronary Disease / therapy
  • Exercise Test
  • Female
  • Heart Rate
  • Humans
  • Male
  • Myocardial Infarction / physiopathology
  • Myocardial Revascularization
  • Odds Ratio
  • Radionuclide Imaging
  • Radiopharmaceuticals*
  • Sex Factors
  • Technetium Tc 99m Sestamibi*

Substances

  • Radiopharmaceuticals
  • Technetium Tc 99m Sestamibi