Résumé
This study aims at predicting the relation between the percentage stenosis through quantitation of the atheroma by using quantitative coronary angiography [QCA] in patients with silent ischemia in comparison to those with manifest one, and studying whether the severity of the lesion could affect the symptoms or not. i.e. patients with more tight lesions have painful ischemia and those with less severe lesions have painless ischemia. QCA is a new technique for accurate estimation of severity of coronary stenosis. The severity of coronary artery disease [CAD] in silent myocardial ischemia is reported by some investigators to be less and by others to be more than manifest ischemia. The relation between CAD severity and symptomatology is also a matter of controversy. Thirty patients were included in this study, half of them had silent and the other half has painful ischemia. Resting ECG, exercise stress test, 24Hs Holter ECG monitoring and coronary angiography were done to all patients. The following QCA parameters were measured [[%diameter stenosis [%DS],%area stenosis [%AS], length of the lesion in mm and plaque area in mm2]. The QCA parameters were compared in the two groups and correlated to patients' symptoms. No significant correlation was found between the severity of the CAD measured by QCA and patients' symptoms. There was a significant relation between the severity of ischemia during stress test and the QCA parameters in both manifest and silent ischemia. [R=0.56, P=0.002, n=30]. Also, the total ischemic burden during 24Hs Holter monitoring gives a significant relation to QCA parameters [R=0.53, P=0.002, n=30] with no significant relation to the symptoms. Severity of the CAD measured by quantitative coronary angiography affects the duration of ischemia during exercise stress test and 24Hs Holter ECG monitoring but not the severity of the symptoms