Coronary Vasospasm Produces Reversible Perfusion Defects Observed During Adenosine Triphosphate Stress Myocardial Single-photon Emission Computed Tomography
Article first published online: 17 JUL 2008
Copyright © 2008 Wiley Periodicals, Inc.
Volume 31, Issue 7, pages 310–316, July 2008
How to Cite
Teragawa, H., Ueda, K., Okuhara, K., Kuwashima, R., Fukuda, Y., Kiguchi, M., Taniguchi, K., Higashi, Y., Oshima, T., Yoshizumi, M. and Chayama, K. (2008), Coronary Vasospasm Produces Reversible Perfusion Defects Observed During Adenosine Triphosphate Stress Myocardial Single-photon Emission Computed Tomography. Clin Cardiol, 31: 310–316. doi: 10.1002/clc.20217
- Issue published online: 17 JUL 2008
- Article first published online: 17 JUL 2008
- Manuscript Revised: 4 JAN 2007
- Manuscript Received: 20 SEP 2006
- vasospastic angina;
- adenosine triphosphate;
- coronary flow reserve
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.
We investigated whether coronary spasm is one of the factors which produces reversible defects on ATP-SPECT.
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).
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).
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. Copyright © 2008 Wiley Periodicals, Inc.