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Ischemia in women with angina and normal coronary angiograms

Amalia Peix1, Ernesto J García, Juan Valiente

  • 1Institute of Cardiology, La Habana, Cuba. peix@infomed.sld.cu

Coronary Artery Disease
|July 14, 2007
PubMed

Insights

Postmenopausal women with angina and normal coronary angiography show stress-induced ischemia linked to reduced left ventricular ejection fraction. This study highlights the connection between myocardial perfusion defects and cardiac function abnormalities.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Vascular Biology

Background:

  • Coronary artery disease is prevalent in postmenopausal women.
  • Endothelial dysfunction is linked to myocardial perfusion defects in stress testing.

Purpose of the Study:

  • To assess if gated single-photon emission computed-tomography myocardial scintigraphy can detect myocardial ischemia through perfusion and function abnormalities.
  • To investigate women with typical angina, normal coronary angiography, and endothelial dysfunction.

Main Methods:

  • Fifty-nine postmenopausal women underwent technetium-99m methoxy-isobutyl-isonitrile myocardial scintigraphy (exercise stress-rest).
  • Brachial artery endothelial function, lipidogram, and 24-h Holter monitoring were assessed.
  • Patients were divided into groups based on scintigraphy findings (perfusion defects vs. no defects).

Main Results:

  • Twenty-one patients (group I) had perfusion defects; 38 (group II) did not.
  • Group I showed higher rates of endothelial dysfunction (57% vs. 29%).
  • Perfusion defects correlated with reduced post-stress left ventricular ejection fraction and regional hypokinesis.

Conclusions:

  • Stress-induced ischemia is associated with reduced post-stress left ventricular ejection fraction in this patient group.
  • A trend towards abnormal endothelial-mediated vasodilation was observed.
  • Gated myocardial scintigraphy effectively identifies ischemia in women with angina and normal coronaries.
Abstract

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