Cardiology Department, Faculty of Medicine, Ain Shams University, P.O. 11381, Abbassia, Cairo, Egypt.
Int J Cardiovasc Imaging. 2014 Feb;30(2):425-30. doi: 10.1007/s10554-013-0331-6. Epub 2013 Nov 22.
We explored the prevalence and pattern of abnormal myocardial perfusion in patients with isolated coronary artery ectasia (CAE), as demonstrated by (99m)Tc-sestamibi scintigraphy. Prospectively, we enrolled 35 patients with angiographically documented CAE and no significant coronary obstruction, who underwent elective coronary angiography. Patients underwent Stress-rest (99m)Tc-sestamibi scintigraphy within 4 days of coronary angiography. They were divided into 2 groups: group I: with normal perfusion scan; and group II: with reversible perfusion defects. The mean age was 49.6 ± 6.9 years; 34 (97.1 %) were males. Seventy-nine (75.2 %) arteries were affected by CAE. Among 79 arteries affected by CAE, affection was diffuse in 37 (46.8 %). Thirteen (37.1 %) patients had normal perfusion scan (group I), whereas 22 (62.9 %) had reversible perfusion defects (group II). Among 22 patients with reversible perfusion defects, 20 (90.9 %) had mild and 2 (9.1 %) had moderate ischemia. Among 49 myocardial segments with reversible perfusion defects, 22 (44.9 %) were basal, 18 (36.7 %) mid-, and 9 (18.4 %) apical segments. Diffuse CAE was significantly more prevalent in group II versus group I, in all 3 major coronary arteries (p < 0.05 for all). In patients with isolated CAE who underwent elective coronary angiography, reversible perfusion defects demonstrated by (99m)Tc-sestamibi scintigraphy were rather prevalent, mostly mild, more likely to affect the basal and mid-segments of the myocardium, and more frequently associated with diffuse ectasia.
我们通过（99m）Tc-甲氧基异丁基异腈闪烁扫描研究了孤立性冠状动脉扩张（CAE）患者异常心肌灌注的发生率和模式。前瞻性地，我们纳入了 35 名经血管造影证实的 CAE 且无明显冠状动脉阻塞的患者，并对其进行了选择性冠状动脉造影。患者在冠状动脉造影后 4 天内进行应激-静息（99m）Tc-甲氧基异丁基异腈闪烁扫描。他们被分为两组：I 组：灌注扫描正常；II 组：可逆性灌注缺损。平均年龄为 49.6 ± 6.9 岁；34 名（97.1%）为男性。79 支动脉受 CAE 影响。在受 CAE 影响的 79 支动脉中，37 支（46.8%）为弥漫性病变。13 名（37.1%）患者灌注扫描正常（I 组），22 名（62.9%）患者有可逆性灌注缺损（II 组）。在 22 名有可逆性灌注缺损的患者中，20 名（90.9%）为轻度，2 名（9.1%）为中度缺血。在 49 个有可逆性灌注缺损的心肌节段中，22 个（44.9%）为基底节段，18 个（36.7%）为中段，9 个（18.4%）为心尖段。在所有 3 支主要冠状动脉中，II 组的弥漫性 CAE 明显多于 I 组（p<0.05）。在接受选择性冠状动脉造影的孤立性 CAE 患者中，（99m）Tc-甲氧基异丁基异腈闪烁扫描显示可逆性灌注缺损相当常见，多为轻度，更可能影响心肌的基底段和中段，并且更常与弥漫性扩张相关。
