[When can normal stress myocardial perfusion scans be observed in patients with chest pain and known or suspected coronary artery disease?].
The aim of this study was to establish characteristic clinical data in patients with normal stress myocardial perfusion scans.


METHODS
99mMIBI scintigraphy was performed following a one-day protocol (stress-rest) in 806 patients (out of them 451 men) with suspected or known coronary artery disease. A bicycle exercise test response was estimated as pathological, non-pathological, borderline and non-informative. Myocardial perfusion was scored according to the size and severity of defect.


RESULTS
Myocardial perfusion was normal in 287 (35.6%) patients. Univariate analysis showed, that normal stress myocardial perfusion scans more often were established in women than in men (p=0.00001, odds ratio 8.55), in patients with atypical anginal or non-anginal chest pain than with typical angina (p=0.0001, odds ratio 1.92), in patients without previous myocardial infarction (p=0.0001, odds ratio 3.28) and without myocardial revascularization (p=0.0001, odds ratio 3.28). The characteristic bicycle exercise test data for normal scans were non-pathological response vs pathological (p=0.00001, odds ratio 3.03) and reason of discontinuance - target heart rate achieved (85% of maximum) vs ischemic changes (p=0.0005, odds ratio 2.37).


CONCLUSIONS
Normal stress myocardial perfusion scans were more often present in women, in patients with atypical angina or non-anginal chest pain, in patients without myocardial infarction and without myocardial revascularization. Achieved target heart rate and non-pathological response to exercise test were commonly observed in patients with normal perfusion scans.
Milvidaite
Irena
I
Institute of Cardiology, Kaunas University of Medicine, Sukileliu 17, 50157 Kaunas, Lithuania. kardlab@kmu.lt
Kulakiene
Ilona
I
Linoniene
Leonarda
L
Gugiene
Laima
L
Rusakeviciene
Elvyra
E
Pauliute
Jūrate
J
D000704:Analysis of Variance; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000503:physiopathology; D015906:Angioplasty, Balloon, Coronary; D002637:Chest Pain / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016009:Chi-Square Distribution; D003326:Coronary Circulation; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery / Q000628:therapy; D005080:Exercise Test; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000503:physiopathology; D009204:Myocardial Revascularization; D016017:Odds Ratio; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012737:Sex Factors; D017256:Technetium Tc 99m Sestamibi
D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi