Abstract
Background
Adenosine triphosphate stress thallium‐201 single‐photon emission computed tomography (ATP‐SPECT) is useful for diagnosing coronary artery disease (CAD), although sometimes false positive results are observed. It has not been established whether a coronary spasm is responsible for the false positive findings during ATP‐SPECT.
Hypothesis
We investigated whether coronary spasm is one of the factors which produces reversible defects on ATP‐SPECT.
Methods
Eighty‐six patients (mean age: 62 y; 58 men) who underwent both spasm‐provocation testing by coronary angiography and ATP‐SPECT, were selected for the study. Patients with coronary narrowing (>30%), myocardial infarction, or heart failure were excluded. Patients were divided into 2 groups based on whether the spasm‐provocation test result was positive (vasospastic angina [VSA] group, n = 46) or negative (non‐VSA group, n = 39).
Results
The body mass index was lower in the VSA group than in the non‐VSA group (p = 0.005). On ATP‐SPECT imaging, any type of reversible defect was observed more frequently in the VSA group (68%) than in the non‐VSA group (36%, p = 0.0027). Logistic regression analysis demonstrated that the presence of reversible defects was one of the factors accounting for the presence of coronary vasospasm (p = 0.0022, R2 = 0.172).
Conclusions
The findings suggest that reversible defects on ATP‐SPECT imaging are frequently present in patients with coronary vasospasm. Coronary spasm may be considered as 1 of the factors, which produce reversible defects on ATP‐SPECT, observed in patients with chest symptoms and angiographically normal coronary arteries. Copyright © 2008 Wiley Periodicals, Inc.
Keywords: vasospastic angina, adenosine triphosphate, coronary flow reserve
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