Tellier P
Centre de Médecine Nucléaire de L'Artois, Clinique Sainte Catherine, Sainte Catherine Les Arras, France.
Angiology. 1994 Oct;45(10):867-75. doi: 10.1177/000331979404501006.
The aim of this study was to evaluate the incidence, type, and severity of asymptomatic leg perfusion abnormalities in 116 male patients with proven coronary artery disease (CAD) who performed near-maximal treadmill test. Interextremity asymmetry was observed in 60% of patients, but the incidence of this sign increased with age (from 35% below forty-five years of age to 72% over sixty-one years). Asymmetry was very marked or marked in 61% of all segments and moderate in 39% of them. A significant decrease in fractional uptake was observed in 21% of patients with CAD and in 25% of those with interextremity asymmetry. Myocardial ischemia, which was defined by reversible defects on myocardial tomoscintigraphy, was three times more frequent in patients with interextremity asymmetry than in patients with normal results from exercise whole-body thallium scintigraphy. This observation, combined with type, extent, and location of asymmetry, is highly suggestive of silent peripheral arterial disease in most cases. Whole-body scan could easily be performed following an exercise myocardial thallium scan so as to provide information on multifocal atherosclerosis in patients with CAD or multiple and severe vascular risk factors. The prognostic value of these silent peripheral muscle perfusion abnormalities remains to be established.
本研究旨在评估116例经证实患有冠状动脉疾病（CAD）且进行了近最大运动平板试验的男性患者无症状腿部灌注异常的发生率、类型和严重程度。60%的患者存在双下肢不对称，但该体征的发生率随年龄增长而增加（从45岁以下的35%增至61岁以上的72%）。所有节段中，61%的不对称非常明显或明显，39%为中度。21%的CAD患者和25%双下肢不对称的患者观察到摄取分数显著降低。根据心肌断层闪烁显像上的可逆性缺损定义的心肌缺血，在双下肢不对称的患者中比运动全身铊闪烁显像结果正常的患者高两倍。结合不对称的类型、范围和部位，这一观察结果在大多数情况下高度提示存在无症状外周动脉疾病。运动心肌铊扫描后可轻松进行全身扫描，以便为CAD患者或具有多种严重血管危险因素的患者提供多灶性动脉粥样硬化的信息。这些无症状外周肌肉灌注异常的预后价值仍有待确定。
