Comparison of Silent Patients with Painful Patients in Patients with Coronary Artery Stenoses during Exercise Myocardial Perfusion Scintigraphy

ABSTRACT

BACKGROUND AND OBJECTIVES: The angiographic profiles and myocardial ischemic variables were compared between patients with and without chest pain during exercise myocardial perfusion scintigraphy in patients with coronary artery stenoses. MATERIALS AND METHODS: Study population were 102 consecutive patients who have significant luminal stenoses (> 50%) on coronary angiography. They underwent symptom-limited treadmill exercise test and myocardial perfusion single photon emission computed tomography (SPECT). Tc-99m methoxylisobutyl isonitrile (MIBI) was injected intravenously at rest and one minute before the termination of exercise. Tomographic images were acquired within 1 hour of tracer injection. Electrocardiographic variables, scintigraphic summed reversibility scores and angiographic profiles were compared between patients with and without chest pain during exercise. RESULTS: Silent ischemia was noted in 52/102 (51%) of the subjects. The summed reversibility score of myocardial SPECT was not significanlty different between patients with (6.0+/-4.2) and without (5.1+/-5.0) chest pain. The extent, vessel distribution and stenosis severity of coronary artery disease were not significantly different between two groups. ST segment depression was more prominent in patients with chest pain (1.51+/-1.49 mm) than without chest pain (0.5+/-1.1 mm) during exercise stress testing. CONCLUSION: The degree of coronary stenoses and scintigraphic myocardial ischemia was not different between patients with and without chest pain during exercise stress testing.