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Titolo:
CORONARY VASOMOTION IN PATIENTS WITH SYNDROME-X - EVALUATION WITH POSITRON EMISSION TOMOGRAPHY AND PARAMETRIC MYOCARDIAL PERFUSION IMAGING
Autore:
MEEDER JG; BLANKSMA PK; VANDERWALL EE; WILLEMSEN ATM; PRUIM J; ANTHONIO RL; DEJONG RM; VAALBURG W; LIE KI;
Indirizzi:
LEIDEN UNIV,MED CTR,DEPT CARDIOL C5 P25,POB 9600 NL-2300 RC LEIDEN NETHERLANDS LEIDEN UNIV,MED CTR,DEPT CARDIOL C5 P25 NL-2300 RC LEIDEN NETHERLANDS UNIV GRONINGEN HOSP,DEPT CARDIOL GRONINGEN NETHERLANDS UNIV GRONINGEN HOSP,PET CTR GRONINGEN NETHERLANDS
Titolo Testata:
European journal of nuclear medicine
fascicolo: 5, volume: 24, anno: 1997,
pagine: 530 - 537
SICI:
0340-6997(1997)24:5<530:CVIPWS>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
BLOOD-FLOW; ANGINA-PECTORIS; ENDOTHELIAL DYSFUNCTION; N-13 AMMONIA; INTRAVASCULAR ULTRASOUND; ARTERY DISEASE; CHEST PAIN; MICROVASCULAR ANGINA; RESERVE; ATHEROSCLEROSIS;
Keywords:
POSITRON EMISSION TOMOGRAPHY; SYNDROME; ENDOTHELIAL FUNCTION; PERFUSION RESERVE; PERFUSION HETEROGENEITY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
45
Recensione:
Indirizzi per estratti:
Citazione:
J.G. Meeder et al., "CORONARY VASOMOTION IN PATIENTS WITH SYNDROME-X - EVALUATION WITH POSITRON EMISSION TOMOGRAPHY AND PARAMETRIC MYOCARDIAL PERFUSION IMAGING", European journal of nuclear medicine, 24(5), 1997, pp. 530-537

Abstract

The aim of this study was to elucidate further the causative mechanism of abnormal coronary vasomotion in patients with syndrome X. In patients with syndrome X, defined as angina pectoris and documented myocardial ischaemia during stress testing with normal findings at coronary angiography, abnormal coronary vasomotion of either the micro- or the macrocirculation has been suggested as the causative mechanism. Accordingly, we evaluated endothelial function, vasodilator reserve, and perfusion heterogeneity in these patients. Twenty-five patients with syndrome X (definitely normal coronary arteriogram, group A), 15 patients with minimal coronary artery disease (group B) and 21 healthy volunteers underwent [N-13]ammonia positron emission tomography at rest, during cold presser stimulation (endothelial function) and during dipyridamole stress testing (vasodilator reserve). Heterogeneity of myocardial perfusion was analysed by parametric polar mapping using a 480-segmentmodel. In both patient groups, resting perfusion was increased compared to the normal subjects: group A, 127+/-31 ml.min(-1).100 g(-1); group B, 124+/-30 ml.min(-1).100 g(-1) normal subjects, 105+/-21 ml.min(-1).100 g(-1) (groups A and B vs normals, P<0.05). These differences were abolished after correction for rate-pressure product. During cold presser stimulation, the perfusion responses (ratio of cold presser perfusion to resting perfusion) were similar among the patients and the control subjects (group A, 1.20+/-0.23; group B, 1.24+/-0.22; normal subjects, 1.23+/-0.14). Likewise, during dipyridamole stress testing, perfusion responses were similar among the three groups (group A, 2.71+/-0.67; group B, 2.77+/-1.29; normal subjects, 2.91+/-1.04). In group Athe heterogeneity of resting perfusion, expressed as coefficient of variation, was significantly different from the volunteers (20.1+/-4.5 vs 17.0+/-3.0, P<0.05), In group B (coefficient of variation 19.4+/-3.9) the difference from normal volunteers was not significant. In this study, patients with syndrome X and patients with minimal coronary artery disease showed normal perfusion responses during cold presser stimulation and dipyridamole stress testing. Our findings therefore suggest that endothelial dysfunction and impaired vasodilator reserve are ofno major pathophysiological relevance in patients with syndrome X. Rather, other mechanisms such as increased sympathetic tone and focal release of vasoactive substances may play a role in the pathogenesis of syndrome X.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/01/20 alle ore 07:39:19