| Myocardial perfusion in patients with permanent ventricular pacing and normal coronary arteries. | |
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MedLine Citation:
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PMID: 11153726 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The purposes of this study were to test the specificity of dipyridamole myocardial perfusion scintigraphy in patients with permanent ventricular pacing (PVP) and to evaluate coronary blood flow and reserve in these patients. BACKGROUND: Permanent ventricular pacing is associated with exercise perfusion defects on myocardial scintigraphy in the absence of coronary artery disease (CAD). On the basis of studies in patients with left bundle brunch block, coronary vasodilation with dipyridamole has been proposed as an alternative to exercise testing for detecting CAD in paced patients, but this approach has never been tested. METHODS: Fourteen patients with a PVP and normal coronary arteries underwent stress thallium-201 scintigraphy and cardiac catheterization. In these patients and in eight control subjects, coronary flow velocities were measured in the left anterior descending coronary artery (LAD) and in the dominant coronary artery before and after adenosine administration. RESULTS: In the paced patients, coronary flow velocities in the LAD and in the dominant coronary artery were significantly lower than those in the control subjects. In addition, seven patients showed perfusion defects on dipyridamole thallium-201 single-photon emission computed tomography, with a specificity of 50% for this test. The defect-related artery in these patients had lower coronary flow reserve (2.6 +/- 0.5) as compared with those without perfusion defects (3.9 +/- 1.0, p < 0.05) or the control group (3.5 +/- 0.5, p < 0.05). CONCLUSIONS: Permanent ventricular pacing is associated with alterations in regional myocardial perfusion. Furthermore, abnormalities of microvascular flow, as indicated by reduced coronary flow reserve in the defect-related artery, are at least partially responsible for the uncertain specificity of dipyridamole myocardial perfusion scintigraphy. |
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Authors:
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E I Skalidis; G E Kochiadakis; S I Koukouraki; S I Chrysostomakis; N E Igoumenidis; N S Karkavitsas; P E Vardas |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 37 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2001 Jan |
Date Detail:
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Created Date: 2001-01-10 Completed Date: 2001-01-25 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 124-9 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology, University Hospital of Heraklion, Crete, Greece. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Blood Flow Velocity / physiology Bundle-Branch Block / physiopathology, radionuclide imaging, therapy Coronary Circulation / physiology* Coronary Disease / physiopathology, radionuclide imaging Diagnosis, Differential Dipyridamole / diagnostic use Exercise Test Female Humans Male Microcirculation / physiopathology Middle Aged Myocardial Ischemia / physiopathology, radionuclide imaging* Pacemaker, Artificial* Thallium Radioisotopes / diagnostic use Tomography, Emission-Computed, Single-Photon* |
| Chemical | |
Reg. No./Substance:
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0/Thallium Radioisotopes; 58-32-2/Dipyridamole |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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