[Detection of myocardial lesions by dipyridamole thallium-201 scintigraphy in patients with rheumatoid arthritis].

Dipyridamole Thallium-201 (T1) scintigraphic studies to evaluate microcirculation of the heart were performed in 54 patients with rheumatoid arthritis (RA) who had neither cardiac complaints nor myocardial damages on ECG. Twenty seven of 54 RA patients showed some perfusion defects in this study. The values of ESR, CRP and rheumatoid factors of IgM and IgG classes were significantly higher in these patients with perfusion defect comparing with those in the rest of RA patients with normal perfusion. The scintigraphic perfusion defects improved relating with the reduction of inflammatory activities of RA. The histological specimens of heart in 12 RA autopsy cases were reviewed to study the etiology of these perfusion defects. In 7 of 12 cases, microvasculitis and microthrombosis were observed without any macroscopic findings compatible with myocardial infarction. Our results suggest that RA patients have frequently microcirculatory disturbances in the heart due to microvasculitis without any clinical symptoms of ECG changes.