[Significance of silent ischemia in dipyridamole perfusion scintigraphy: evaluation in patients with angina].

The significance of silent myocardial ischemia detected by dipyridamole perfusion scintigraphy was evaluated in 80 patients with stable angina and reversible defects (RD) but no infarction. The patients were divided into two groups: 26 patients with silent RD (62 +/- 7 years) and 54 patients with painful RD (65 +/- 7 years). Coronary risk factors, extent of coronary lesions, localization and degree of RD, and prognosis were compared. There was no significant difference in the incidence of coronary risk factors between these two groups, except for hyperlipidemia which was less frequently observed in patients with silent RD than in those with painful RD (8% vs 41%, p < 0.01). Coronary angiography revealed a higher prevalence of insignificant lesions or single vessel disease in patients with silent RD than in those with painful RD (73% vs 39%, p < 0.05). Dipyridamole perfusion scintigraphy revealed a lower degree of RD in patients with silent RD than in those with painful RD (4.4 +/- 3.3 vs 9.0 +/- 4.1 segments, p < 0.05), though there was no significant difference in the localization of RD between these two groups. Treadmill stress testing revealed a lower incidence of chest pain in patients with silent RD than in those with painful RD (26% vs 65%, p < 0.05), despite the mean exercise-duration being significantly longer in the former than in the latter (5.5 +/- 1.7 vs 3.9 +/- 1.7 min, p < 0.05). There was no significant correlation between the late peak serum ML-1 level and LV volume, and the size and motion of infarcted areas in group B.(ABSTRACT TRUNCATED AT 250 WORDS)