Thallium-201 stress scintigraphy in Takayasu arteritis.
Thirty-eight women with Takayasu arteritis were studied using thallium-201 stress myocardial scintigraphy to assess the prevalence and pathophysiology of the perfusion abnormality. Twenty (53%) had abnormal scintigraphic findings (group A). Abnormal scans were divided into 3 groups: permanent defects in 6, reversible defects in 7 and slow washout in 7. The remaining 18 patients had normal scintigrams (group N). Group A had a tendency to be older and to have a high prevalence of complicated significant aortic regurgitation. Interventricular thickness plus left ventricular posterior wall thickness (26 +/- 7 vs 17 +/- 2 mm, p less than 0.01) and left ventricular mass (267 +/- 121 vs 133 +/- 39 g, p less than 0.01) were all greater in group A on echocardiography. The mean value of the central aortic pressure in systole was 170 +/- 15 mm Hg in the 7 catheterized patients in group A. Coronary ostial stenoses were present in 2 group A patients who showed reversible defects on scintigrams. These data indicate that the abnormal perfusion detected by imaging in patients with Takayasu arteritis was responsible for a decrease in coronary reserve or myocardial damage, or both, due to long-standing systemic hypertension or aortic regurgitation. Coronary artery disease should be considered if a reversible defect is present.
Hashimoto
Y
Y
Third Department of Internal Medicine, Tokyo Medical and Dental University, School of Medicine, Japan.
Numano
F
F
Maruyama
Y
Y
Oniki
T
T
Kasuya
K
K
Kakuta
T
T
Wada
T
T
Yajima
M
M
Maezawa
H
H
D000328:Adult; D000367:Age Factors; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology; D004176:Dipyridamole / Q000494:pharmacology; D004452:Echocardiography; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D013625:Takayasu Arteritis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013794:Thallium Radioisotopes; D014055:Tomography, Emission-Computed; D016277:Ventricular Function, Left / Q000502:physiology
D013794:Thallium Radioisotopes; D004176:Dipyridamole