[Quantification of myocardial ischemia in regions dependent on occluded coronary arteries in patients without previous infarction].
OBJECTIVE
The aim of this study is to assess myocardial ischemia in regions with no infarction dependent occluded coronary arteries.


METHODS
149 patients with proved coronary artery disease and without previous myocardial infarction were studied by 99mTc-MIBI SPECT (long protocol) and coronary angiography. The extent of the uptake reversibility was quantified in 3 regions (antero-septal, inferior and lateral) of the polar maps, assessing the percentage of each region that had a > 10% difference resulting from the rest uptake minus the stress uptake. The regions dependent on one occluded artery were compared to those dependent on non-occluded arteries. In the regions dependent on one occluded artery a comparison was also made between those which had a good collateral circulation and those which did not.


RESULTS
Fifty-four out of 149 patients (36%) had at least one occluded coronary artery (20 anterior descending, 22 right and 27 circumflex coronary arteries). In the visual analysis, reversible defects were observed in all patients with occlusion of the anterior descending and the right coronary artery, but only in half of the occlusions of the circumflex coronary artery. The extent of this reversibility was significantly higher in the regions dependent on occluded arteries and was highly variable, though lower when good collateral circulation was present.


CONCLUSIONS
Reversible defects were always observed in the occlusions of the left anterior descending and right coronary arteries, but only in half of those of the circumflex artery. The extent of the ischemia was higher in the regions dependent on one occluded coronary artery, mainly when there was an absence of good collateral circulation.
Santana Boado
C
C
Servicio de Cardiología, Hospital General Universitari Vall d'Hebron, Barcelona.
Candell Riera
J
J
Aguadé Bruix
S
S
Castell Conesa
J
J
Bermejo Fraile
B
B
Canela Coll
T
T
Valenzuela Juan
H
H
Missorici
M
M
Soler Soler
J
J
D000368:Aged; D006328:Cardiac Catheterization; D003097:Collateral Circulation; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003326:Coronary Circulation; D003627:Data Interpretation, Statistical; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000000981:diagnostic imaging; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi
Cuantificación de la isquemia miocárdica en regiones dependientes de arterias coronarias ocluidas de pacientes sin infarto previo.