Detection of angina-provoking coronary stenosis by resting iodine 123 metaiodobenzylguanidine scintigraphy in patients with unstable angina pectoris.
Resting iodine 123-labeled metaiodobenzylguanidine (123I-MIBG) scintigraphy was performed in 19 patients with unstable angina to determine if it can detect myocardial ischemia and identify the angina-provoking coronary artery. Visual assessment of 123I-MIBG single-photon-emission computed tomograms was related to coronary vessel stenoses revealed by arteriography at each vascular territory. Fourteen (74%) of 19 patients had regional 123I-MIBG-identified defects at areas with preserved thallium-201 perfusion. 123I-MIBG defects were highly positive at areas supplied by angina-provoking coronary arteries. The sensitivity and specificity of 123I-MIBG defects for identifying the angina-provoking coronary vessel were 71% and 78%, respectively. The interval between the most recent angina attack and imaging was shorter and the angina occurred more commonly after admission in patients with 123I-MIBG defects than in those without defects. These data suggest that repetitive myocardial ischemia impairs regional 123I-MIBG uptake and that this impairment persists for several days after perfusion has been restored. Thus resting 123I-MIBG scintigraphy is a useful noninvasive method to detect coronary stenoses provoking repetitive ischemia in patients with unstable angina in its acute phase.
Tsutsui
H
H
Research Institute of Angiocardiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Ando
S
S
Fukai
T
T
Kuroiwa
M
M
Egashira
K
K
Sasaki
M
M
Kuwabara
Y
Y
Koyanagi
S
S
Takeshita
A
A
D019797:3-Iodobenzylguanidine; D000368:Aged; D000789:Angina, Unstable / Q000000981:diagnostic imaging* / Q000209:etiology; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008297:Male; D012680:Sensitivity and Specificity; D013794:Thallium Radioisotopes; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon
D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D013794:Thallium Radioisotopes; D019797:3-Iodobenzylguanidine