Study of the predictors and lesion characteristics of ischemic heart disease patients with false negative results in stress myocardial perfusion single-photon emission tomography.
BACKGROUND
The predictors and lesion morphology of patients with ischemic heart disease testing false negative results in stress myocardial perfusion single-photon emission computed tomography (SPECT) was investigated.


RESULTS
Subjects were 58 consecutive patients who underwent coronary angiography (CAG), even though they showed normal findings in stress myocardial perfusion SPECT. Age, gender, methods of stress, perfusion agent, coronary risk factors, angina symptoms, and electrocardiographic changes were investigated as predictors by multivariate analysis. For lesion morphology, significant stenotic lesions were studied for morphological characteristics and reference diameter (RD), percentage diameter stenosis (%DS), minimum lumen diameter (MLD), and lesion length (LL) were measured. CAG revealed 30 significant stenotic lesions in 18 patients. Logistic regression analysis revealed significant predictors to be age (odds ratio (OR) 1.118, p<0.05), typical anginal pain (OR 21.09, p<0.01), and hypertension (OR 8.336, p<0.05). For lesion morphology, there were only 2 diffuse lesions and the mean RD, %DS, MLD, and LL were 3.03+/-0.9 mm, 63.1 +/-9.3%, 1.13+/-0.49 mm, and 13.2+/-7.0 mm, respectively.


CONCLUSIONS
Sufficient caution is believed necessary in the interpretation of normal findings of stress myocardial perfusion SPECT when the patient is elderly, complains of typical anginal pain, or has hypertension. In regard to characteristics of lesion morphology, there were hardly any diffuse lesions.
Fujimoto
Shinichiro
S
Division of Interventional Cardiology, Cardiovascular Center, Toho University School of Medicine, Tokyo, Japan. s-fujimo@tj8.so-net.ne.jp
Wagatsuma
Kenji
K
Uchida
Yasuto
Y
Nii
Hideo
H
Nakano
Masatsugu
M
Toda
Mikihito
M
Yamashina
Shohei
S
Yamazaki
Junichi
J
D000367:Age Factors; D000368:Aged; D000787:Angina Pectoris / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D017023:Coronary Angiography; D005080:Exercise Test; D005188:False Negative Reactions; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology*; D009206:Myocardium / Q000473:pathology*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012189:Retrospective Studies; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods / Q000592:standards*