Pattoneri P, Astorri E, Calbiani B, Agnese G
Unit of Cardiology, Department of Clinical Sciences, University of Parma, Parma, Italy.
Minerva Cardioangiol. 2003 Feb;51(1):87-91, 91-3.
Wolff-Parkinson-White syndrome (WPW) is known to cause abnormal rest electrocardiogram and stress test. Thallium-201 myocardial scintigraphy has been particularly indicated for the noninvasive evaluation of coronary artery disease in these patients. The study group consisted of 11 WPW patients with abnormal ST-segment depression at rest electrocardiogram and/or stress test, with the absence of signs or symptoms of coronary artery disease. All the patients underwent exercise thallium-201 imaging associated with stress test by bicycle ergometer: 7 of them had ST-segment depression, but without other signs or symptoms of coronary artery disease. Transient and moderate myocardial perfusion defects were found in 5 of 11 patients. Perfusion defects in patients with WPW could derive from dyssynergy of ventricular activation, which could modify myocardial perfusion scintigraphy despite the absence of angiographic coronary stenosis. Previous reports and our data concluded that transient perfusion defects during exercise thallium-201 testing in WPW patients without cardiovascular disease may be observed. Thus, thallium-201 myocardial scintigraphy could present some limitations as a helpful adjunctive method for assessment of coronary artery disease in WPW patients.
已知预激综合征（WPW）会导致静息心电图和负荷试验异常。铊-201心肌闪烁扫描术尤其适用于对这些患者的冠状动脉疾病进行无创评估。研究组由11例WPW患者组成，这些患者在静息心电图和/或负荷试验中有ST段压低，且无冠状动脉疾病的体征或症状。所有患者均接受了与自行车测力计负荷试验相关的运动铊-201显像：其中7例有ST段压低，但无其他冠状动脉疾病的体征或症状。11例患者中有5例发现短暂性和中度心肌灌注缺损。WPW患者的灌注缺损可能源于心室激活失调，尽管没有血管造影显示冠状动脉狭窄，但这可能会改变心肌灌注闪烁扫描结果。既往报告和我们的数据表明，在无心血管疾病的WPW患者进行运动铊-201试验期间可能会观察到短暂性灌注缺损。因此，铊-201心肌闪烁扫描术作为评估WPW患者冠状动脉疾病的一种辅助方法可能存在一些局限性。
