Hakki A H, Iskandrian A S, Kane S A, Amenta A
Am Heart J. 1984 Aug;108(2):326-32. doi: 10.1016/0002-8703(84)90619-7.
The purpose of this study was to examine the rest thallium-201 perfusion pattern during angina-free periods in 40 patients with rest angina pectoris secondary to coronary artery disease (greater than or equal to 70% diameter narrowing). Seventeen patients had previous Q wave myocardial infarction. The perfusion defects were considered fixed or reversible, depending on the absence or presence of redistribution in the 4-hour delayed images. There were 40 perfusion defects (26 fixed and 14 reversible) in 27 patients whereas 13 patients had normal scans. Reversible perfusion defects were present in 10 patients (25%). Of the 26 fixed perfusion defects, 17 did not have corresponding Q waves. Occluded vessels (63%) had more perfusion defects than vessels with subtotal occlusion (30%) (p less than 0.01). The perfusion defect size was larger in patients with lower ejection fraction than in patients with higher ejection fraction. We conclude: (1) perfusion defects are common in patients with rest angina and are reversible in 25% of patients indicating reduced regional coronary blood flow; (2) the degree of stenosis affects the presence of perfusion defect; (3) fixed defects may be present without corresponding Q waves; and (4) global left ventricular function is related to the size of perfusion defects.
本研究旨在检查40例因冠状动脉疾病（直径狭窄大于或等于70%）导致静息性心绞痛的患者在无心绞痛发作期间的静息铊-201灌注模式。17例患者曾有Q波型心肌梗死。根据4小时延迟图像中是否存在再分布情况，将灌注缺损分为固定性或可逆性。27例患者存在40个灌注缺损（26个固定性和14个可逆性），而13例患者扫描结果正常。10例患者（25%）存在可逆性灌注缺损。在26个固定性灌注缺损中，17个没有相应的Q波。闭塞血管（63%）的灌注缺损比次全闭塞血管（30%）更多（p<0.01）。射血分数较低的患者灌注缺损大小比射血分数较高的患者更大。我们得出结论：（1）静息性心绞痛患者中灌注缺损常见，25%的患者存在可逆性灌注缺损，提示局部冠状动脉血流减少；（2）狭窄程度影响灌注缺损的存在；（3）固定性缺损可能在没有相应Q波的情况下出现；（4）左心室整体功能与灌注缺损大小相关。
