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Coronary vasospasm produces reversible perfusion defects observed during adenosine triphosphate stress myocardial

Hiroki Teragawa1, Kentaro Ueda, Koichiro Okuhara

  • 1Department of Medicine and Molecular Science, Hiroshima University Hospital, Hiroshima, Japan. hteraga@hiroshima-u.ac.jp

Clinical Cardiology
|July 19, 2008
PubMed

Insights

Coronary artery spasm frequently causes false positives in adenosine triphosphate stress thallium-201 single-photon emission computed tomography (ATP-SPECT) scans. This study confirms coronary spasm as a cause of reversible defects on ATP-SPECT imaging.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Diagnostic Imaging

Background:

  • Adenosine triphosphate stress thallium-201 single-photon emission computed tomography (ATP-SPECT) aids in diagnosing coronary artery disease (CAD).
  • False positive results can occur with ATP-SPECT, but the role of coronary spasm in these findings is unclear.

Purpose of the Study:

  • To determine if coronary spasm contributes to reversible defects observed in ATP-SPECT imaging.
  • To investigate the association between coronary vasospasm and ATP-SPECT findings.

Main Methods:

  • Eighty-six patients underwent both coronary angiography with spasm-provocation testing and ATP-SPECT.
  • Patients were categorized into vasospastic angina (VSA) positive (n=46) and non-VSA (n=39) groups.
  • Exclusion criteria included significant coronary narrowing, myocardial infarction, or heart failure.

Main Results:

  • The VSA group had a lower body mass index compared to the non-VSA group (p=0.005).
  • Reversible defects on ATP-SPECT were significantly more frequent in the VSA group (68%) than the non-VSA group (36%, p=0.0027).
  • Logistic regression identified reversible defects as a factor associated with coronary vasospasm (p=0.0022, R2=0.172).

Conclusions:

  • Reversible defects on ATP-SPECT are common in patients with coronary vasospasm.
  • Coronary spasm should be considered a potential cause of reversible defects on ATP-SPECT in patients with chest symptoms and normal coronary arteries.
Abstract

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