Myocardial ischaemia in patients with peripheral arterial disease.
OBJECTIVE
To study the relation between myocardial ischemia assessed with different techniques in patients with peripheral arterial disease (PAD) in comparison with a matched control group.


METHODS
Ninety-nine male patients with PAD and 94 age- and sex-matched control subjects without PAD or ischaemic heart disease performed a exercise treadmill test, dipyridamole Tc-99m sestamibi myocardial perfusion SPECT (MPS) (43 controls) and 48-h ambulatory ECG (AECG)-monitoring (43 controls).


RESULTS
Thirteen of 99 patients had irreversible and 24 of 99 had reversible perfusion defects in MPS in comparison with 0 of 43 and six of 43 of control subjects respectively (P<0.01). Thirteen of 84 evaluable patients experienced a total of 36 episodes of ST-depression in AECG in comparison with two episodes in two of 42 control subjects (P = 0.07). Out of 13 patients with ST-depression episodes only three had reversible ischaemia in MPS.


CONCLUSIONS
Most PAD patients with episodes of ST-segment depression have no reversible ischaemia as assessed with dipyridamole-stress MPS. Episodes of ST-segment depression may reflect types of myocardial ischaemia that are different from those detected by MPS.
Svensson
Per
P
Department of Emergency Medicine, Karolinska Hospital, Stockholm, Sweden. per.svensson@karolinska.se
de Faire
Ulf
U
Niklasson
U
U
Ostergren
Jan
J
D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography / Q000379:methods*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications* / Q000175:diagnosis*; D016491:Peripheral Vascular Diseases / Q000150:complications* / Q000175:diagnosis*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*