Coronary vasospasm produces reversible perfusion defects observed during adenosine triphosphate stress myocardial single-photon emission computed tomography.
BACKGROUND
Adenosine triphosphate stress thallium-201 single-photon emission computed tomography (ATP-SPECT) is useful for diagnosing coronary artery disease (CAD), although sometimes false positive results are observed. It has not been established whether a coronary spasm is responsible for the false positive findings during ATP-SPECT.


OBJECTIVE
We investigated whether coronary spasm is one of the factors which produces reversible defects on ATP-SPECT.


METHODS
Eighty-six patients (mean age: 62 y; 58 men) who underwent both spasm-provocation testing by coronary angiography and ATP-SPECT, were selected for the study. Patients with coronary narrowing (>30%), myocardial infarction, or heart failure were excluded. Patients were divided into 2 groups based on whether the spasm-provocation test result was positive (vasospastic angina [VSA] group, n = 46) or negative (non-VSA group, n = 39).


RESULTS
The body mass index was lower in the VSA group than in the non-VSA group (p = 0.005). On ATP-SPECT imaging, any type of reversible defect was observed more frequently in the VSA group (68%) than in the non-VSA group (36%, p = 0.0027). Logistic regression analysis demonstrated that the presence of reversible defects was one of the factors accounting for the presence of coronary vasospasm (p = 0.0022, R2 = 0.172).


CONCLUSIONS
The findings suggest that reversible defects on ATP-SPECT imaging are frequently present in patients with coronary vasospasm. Coronary spasm may be considered as 1 of the factors, which produce reversible defects on ATP-SPECT, observed in patients with chest symptoms and angiographically normal coronary arteries.
Teragawa
Hiroki
H
Department of Medicine and Molecular Science, Hiroshima University Hospital, Hiroshima, Japan. hteraga@hiroshima-u.ac.jp
Ueda
Kentaro
K
Okuhara
Koichiro
K
Kuwashima
Rieko
R
Fukuda
Yukihiro
Y
Kiguchi
Masao
M
Taniguchi
Kingo
K
Higashi
Yukihito
Y
Oshima
Tetsuya
T
Yoshizumi
Masao
M
Chayama
Kazuaki
K
D000255:Adenosine Triphosphate / Q000008:administration & dosage; D000368:Aged; D016022:Case-Control Studies; D002637:Chest Pain / Q000209:etiology; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology; D023921:Coronary Stenosis / Q000175:diagnosis; D003329:Coronary Vasospasm / Q000000981:diagnostic imaging*; D004452:Echocardiography; D005080:Exercise Test; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
D013794:Thallium Radioisotopes; D000255:Adenosine Triphosphate