title: [Thallium-201 myocardial scintigraphy in patients with normal coronary arteries and normal left ventriculogram - comparison with hemodynamics, metabolic and morphologic findings (author's transl)].
abstract: 36 consecutive patients with chest pain and/or severe ventricular dysrhythmias, but normal coronary arteries and normal left ventriculogram, underwent thallium-201 myocardial imaging at rest and during exercise. The myocardial scintigram was abnormal in 27 patients (group A) and normal in only 9 patients patients (group B). To answer the question, whether the scintigram was false positive or a correct expression of a myocardial disorder not detectable with angiocardiographic methods, we compared the scintigraphic results with the findings of resting and exercise ECG (n = 36), mean pulmonary artery pressure during exercise (n = 27), myocardial lactate extraction during highrate atrial pacing (n = 14) and light- and electronmicropic examination of right ventricular endomyocardial biopsies (n = 14). The resting ECG was abnormal in 7 of 27 patients of group A and 1 of 9 patients of group B, the exercise ECG in 20 of 27 patients of group A and 1 of 9 patient B. An abnormally elevated exercise pulmonary artery pressure was measured in 10 of 21 patients of group A and 1 of 6 patients of group B. High rate atrial pacing induced an abnormal myocardial lactate extraction in 3 of 13 patients of group A, but not in the single investigated patient of group B. All 12 examined patients of group A and 1 of 2 patients of group B had abnormal biopsy findings. The high incidence of abnormal findings in group A compared to the rare incidence in group B suggests, that the abnormal myocardial scintigrams in patients with chest pain and normal coronary arteries is likely not false positive but reflects a myocardial disorder not being recognized on angiography.
mesh_terms: D000328:Adult; D001794:Blood Pressure; D009202:Cardiomyopathies / Q000175:diagnosis; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007773:Lactates / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000648:ultrastructure; D005082:Physical Exertion; D011651:Pulmonary Artery; D011868:Radioisotopes; D011877:Radionuclide Imaging; D013793:Thallium
chemical_list: D007773:Lactates; D011868:Radioisotopes; D013793:Thallium
vernacular_title: Thallium-201-Myokardszintigraphie bei Patienten mit normalen Koronararterien und normalem AVentrikulogramm - Vergeich mit hämodynamischen, metabolischen und morphologischen Befunden.