Exercise-induced silent myocardial ischemia in patients with vasospastic angina.
To clarify the incidence and clinical characteristics of exercise-induced myocardial ischemia in patients with vasospastic angina, we performed exercise thallium computed tomography in 25 patients who had no significant coronary artery stenosis greater than 70%. Coronary artery spasm was documented by coronary angiography in all patients. Eleven patients (44%) developed exercise-induced perfusion defects, but only four of them had anginal pain (36%). Diltiazem (90 mg, administered orally) prevented the development of exercise-induced perfusion defects in all patients. Multivessel coronary spasm was documented by coronary angiography in 11 patients, and nine of them (82%) showed exercise-induced perfusion defects (p less than 0.05).


CONCLUSIONS
(1) Exercise-induced myocardial ischemia was demonstrated in 44% of patients who had vasospastic angina without fixed coronary stenosis, and 64% of them were asymptomatic. (2) Patients with multivessel spasm had a greater prevalence of exercise-induced myocardial ischemia than those with single-vessel spasm.
Aoki
M
M
Research Institute of Angiocardiology, Kyushu University, Fukuoka, Japan.
Koyanagi
S
S
Sakai
K
K
Irie
T
T
Takeshita
A
A
Nakamura
M
M
Nakagaki
O
O
D000788:Angina Pectoris, Variant / Q000150:complications*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000209:etiology*; D004110:Diltiazem; D004562:Electrocardiography; D015444:Exercise; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D013794:Thallium Radioisotopes; D004110:Diltiazem