Author + information
- Received March 8, 1985
- Revision received July 8, 1985
- Accepted July 16, 1985
- Published online December 1, 1985.
- Victor Legrand, MDb,
- John McB. Hodgson, MD,
- Eric R. Bates, MD,
- Fred M. Aueron, MD,
- G.B. John Mancini, MD, FRCP(C), FACC,
- Joseph S. Smith, MD,
- Milton D. Gross, MD and
- Robert A. Vogel, MD, FACCa
- ↵aAddress for reprints: Robert A. Vogel, MD, Cardiology Section, Veterans Administration Medical Center, 2215 Fuller Road, Ann Arbor, Michigan 44105.
Coronary flow reserve, exercise thallium-201 scintigraphy and exercise radionuclide ventriculography were compared in 18 patients with chest pain and angiographically normal coronary arteries. Regional exercise thallium-201 perfusion was abnormal in three patients, regional exercise wall motion was abnormal in three other patients and results of both tests were abnormal in one additional patient. Left ventricular ejection fraction responses were abnormal in five of these seven patients. The coronary flow reserve of arterial distributions with abnormal perfusion or regional dysfunction was significantly lower than that of distributions associated with normal radionuclide results (1.42 ± 0.23 versus 2.58 ± 0.83, p < 0.001).
All patients with abnormal scintigraphic results had low coronary flow reserve (<1.95) in at least one distribution. Perfusion abnormalities appeared to be more localized in the arterial distributions with the lowest flow reserve. Only two patients had low flow reserve (<1.95) with normal scintigraphic results; both were hypertensive. These data suggest that abnormal exercise scintigraphic findings in patients with angiographically normal coronary arteries and chest pain are indicative of true blood flow or perfusion abnormalities.
↵b Dr. Legrand is a recipient of a NATO Scientific Research Grant Brussels, Belgium).
This work was supported in part by research funds of the Michigan Heart Association, Lathrup Village, Michigan and the Veterans Administration.
- Received March 8, 1985.
- Revision received July 8, 1985.
- Accepted July 16, 1985.
- American College of Cardiology Foundation