Document Detail

Silent ischemia: evaluation by exercise and redistribution tomographic thallium-201 myocardial imaging.
MedLine Citation:
PMID:  2794274     Owner:  NLM     Status:  MEDLINE    
To compare the amount of myocardium jeopardized during silent ischemia and painful ischemia, 112 consecutive patients undergoing coronary arteriography with ischemia demonstrated by exercise and redistribution tomographic thallium-201 myocardial imaging (SPECT) were divided into two groups: 84 patients without anginal pain (silent ischemia) and 28 with pain (painful ischemia). The SPECT apical, mid and basal ventricular levels of the short-axis view and the apical portion of the long-axis view were divided into 20 segments. The results were 1) 7.4 +/- 4.7 ischemic segments in silent ischemia and 7.6 +/- 3.7 in painful ischemia (p = NS) with 4.7 +/- 3.6 segments in silent ischemia undergoing total redistribution compared with 5.4 +/- 3.4 in painful ischemia (p = NS); 2) no difference in the incidence of single, double or triple vessel disease between silent and painful ischemic groups; 3) similar anatomic distribution of ischemic segments between the two groups; 4) more positive exercise electrocardiographic (ECG) changes in painful ischemia (70%) than in silent ischemia (32%) (p less than 0.001) with equal amounts of ischemia associated with positive and negative exercise ECG findings. Conclusions: 1) Patients with silent and painful ischemia during exercise have similar amounts of ischemic myocardium demonstrated by tomographic thallium-201 imaging and similar extent of angiographically documented coronary artery disease despite the absence of pain and the lower incidence of positive exercise ECG findings in silent ischemia. 2) Positive and negative exercise ECG findings were associated with similar amounts of ischemic myocardium.
H S Hecht; R E Shaw; T Bruce; R K Myler
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  14     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1989 Oct 
Date Detail:
Created Date:  1989-11-14     Completed Date:  1989-11-14     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  895-900     Citation Subset:  AIM; IM    
San Francisco Heart Institute, Seton Medical Center, Daly City, California 94015.
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MeSH Terms
Angina Pectoris / radionuclide imaging
Coronary Angiography
Coronary Disease / radionuclide imaging*
Exercise Test
Heart / radionuclide imaging*
Middle Aged
Physical Exertion*
Tomography, Emission-Computed, Single-Photon*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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