title: Influence of exercise-induced coronary artery spasm on thallium-201 initial distribution and washout kinetics in patients with variant and classic angina pectoris.
abstract: Thallium-201 single-photon emission computed tomography was performed immediately, and 2 and 4 hours after exercise-induced anginal attack in 2 groups of patients with either exercise-induced coronary spasm or severe fixed stenosis on the isolated proximal left anterior descending coronary artery. All patients with variant angina had transient ST-segment elevation during the exercise-induced attack for thallium-201 scintigraphic study. Both perfusion defects and 4-hour washout abnormalities were significantly greater in patients with variant angina than in those with stable effort angina (p < 0.01). In patients with stable effort angina, thallium-201 activity in ischemic regions (as a percentage of initial count in the normal region) progressively decreased, whereas in patients with variant angina it increased from 38% (initial) to 48% (2 hours), and then declined to 42% (4 hours). The initial normalized thallium-201 activity in the ischemic regions was significantly lower in patients with variant angina than in those with stable effort angina (p < 0.001). In conclusion, perfusion and washout abnormalities during exercise-induced angina are greater in patients with variant angina than in those with stable effort angina. Exercise-induced coronary spasm seems to contribute to the profound reduction in initial thallium-201 distribution and delayed thallium-201 accumulation in the ischemic region.
authors.affiliation: Division of Cardiology, Kumamoto University School of Medicine, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Motomura
authors.forename: K
authors.initials: K
authors.lastname: Kugiyama
authors.forename: H
authors.initials: H
authors.lastname: Yasue
authors.forename: K
authors.initials: K
authors.lastname: Minoda
authors.forename: K
authors.initials: K
authors.lastname: Okumura
authors.forename: Y
authors.initials: Y
authors.lastname: Inobe
authors.forename: S
authors.initials: S
authors.lastname: Tomiguchi
authors.forename: A
authors.initials: A
authors.lastname: Kojima
authors.forename: M
authors.initials: M
authors.lastname: Takahashi
mesh_terms: D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging* / Q000209:etiology / Q000378:metabolism; D000788:Angina Pectoris, Variant / Q000000981:diagnostic imaging; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013794:Thallium Radioisotopes / Q000493:pharmacokinetics; D013997:Time Factors; D014018:Tissue Distribution; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D013794:Thallium Radioisotopes