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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Clinical characteristics in patients showing ischemic electrocardiographic changes during adenosine triphosphate

Yuka Ohtaki1, Taishiro Chikamori, Satoshi Hida

  • 1Department of Cardiology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan. yuka-o@tokyo-med.ac.jp

Journal of Cardiology
|March 31, 2010
PubMed

Insights

Ischemic ST-segment changes during adenosine triphosphate (ATP) loading myocardial SPECT are rare but can indicate severe coronary artery disease (CAD). Patients with perfusion abnormalities require careful consideration for revascularization.

Area of Science:

  • Cardiology
  • Nuclear Medicine
  • Diagnostic Imaging

Background:

  • Electrocardiographic (ECG) changes during dipyridamole or adenosine infusion are known markers for severe coronary artery disease (CAD).
  • Limited research exists on ST-segment changes during adenosine triphosphate (ATP)-loading myocardial single-photon emission computed tomography (SPECT).

Purpose of the Study:

  • To investigate the occurrence and significance of ST-segment changes during ATP-loading myocardial SPECT.
  • To assess the association between ST-segment changes and the severity of coronary artery disease.

Main Methods:

  • A retrospective analysis of 3238 patients undergoing ATP-loading SPECT between January 2003 and August 2008.
  • Exclusion criteria included left bundle branch block, pacemaker rhythm, or prior coronary revascularization.
  • Correlation of ST-segment changes with myocardial perfusion imaging and coronary angiography findings.

Main Results:

  • Ischemic ST-segment depression was observed in only 0.5% (16 out of 3238) of patients.
  • Among patients with ST-segment depression, 8 showed perfusion abnormalities, with 5 having significant CAD (left main, 3-vessel, or proximal LAD occlusion).
  • No major cardiac events occurred in the 8 patients with normal SPECT and ST-segment depression.

Conclusions:

  • Ischemic ST-segment changes during ATP loading are a rare finding.
  • This finding, especially with perfusion abnormalities, may signify severe CAD requiring intervention.
  • ATP-loading SPECT can reveal significant CAD, even with rare ECG changes.
Abstract

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