Eber B, Lind P, Dusleag J, Langsteger W, Eber O, Klein W
Medizinische Universitätsklinik, Graz.
Wien Klin Wochenschr. 1989 Sep 15;101(17):574-9.
Silent myocardial ischemia is defined as true myocardial ischemia without angina pectoris in patients with angiographically detected coronary artery disease. In this study 52 patients (46 male, 8 female: mean age 53 years) with a pathological exercise test but no symptoms were investigated. They showed stenosis of 75% or more of the diameter in at least one coronary segment on angiography. Prior to or after catheterization (within 14 days) Tl-201 SPECT was done and evaluated independently of angiography. A clear correlation between angiographically confirmed stenosis and reversible perfusion defects with Tl-201 SPECT was established (62 out of 76 lesions). Furthermore, there was a significant relation between angiographically detected subtotal or total occlusions of coronary vessels and irreversible perfusion defects using Tl-201 SPECT (35 in 44 lesions) (p less than 0.001). In patients with ST depression but without angina pectoris during the exercise test, the Tl-201 SPECT is highly suited to determine the hemodynamic effect of coronary stenoses.
无症状性心肌缺血被定义为在经血管造影检测出患有冠状动脉疾病的患者中，存在真正的心肌缺血但无胸痛症状。在本研究中，对52例（46例男性，8例女性；平均年龄53岁）运动试验结果异常但无症状的患者进行了调查。血管造影显示，他们至少有一个冠状动脉节段的直径狭窄达75%或以上。在导管插入术前或术后（14天内）进行了铊-201单光子发射计算机断层扫描（Tl-201 SPECT），且独立于血管造影进行评估。血管造影证实的狭窄与Tl-201 SPECT显示的可逆性灌注缺损之间建立了明确的相关性（76个病变中有62个）。此外，血管造影检测到的冠状动脉血管次全闭塞或完全闭塞与使用Tl-201 SPECT显示的不可逆灌注缺损之间存在显著相关性（44个病变中有35个）（p<0.001）。在运动试验期间出现ST段压低但无胸痛的患者中，Tl-201 SPECT非常适合用于确定冠状动脉狭窄的血流动力学效应。
