When can normal stress myocardial perfusion scans be observed in patients with chest pain and known or suspected coronary artery disease?

• Published in: Medicina (Kaunas, Lithuania) Vol. 40; no. 7; p. 627
• Main Authors: Milvidaite, Irena, Kulakiene, Ilona, Linoniene, Leonarda, Gugiene, Laima, Rusakeviciene, Elvyra, Pauliute, Jūrate
• Format: Journal Article
• Language: Lithuanian
• Published: Switzerland 2004
• Subjects: Analysis of Variance; Angina Pectoris - diagnostic imaging; Angina Pectoris - physiopathology; Angioplasty, Balloon, Coronary; Chest Pain - diagnostic imaging; Chest Pain - physiopathology; Chi-Square Distribution; Coronary Circulation; Coronary Disease - diagnostic imaging; Coronary Disease - physiopathology; Coronary Disease - surgery; Coronary Disease - therapy; Exercise Test; Female; Heart Rate; Humans; Male; Myocardial Infarction - physiopathology; Myocardial Revascularization; Odds Ratio; Radionuclide Imaging; Radiopharmaceuticals; Sex Factors; Technetium Tc 99m Sestamibi
• ISSN: 1648-9144

The aim of this study was to establish characteristic clinical data in patients with normal stress myocardial perfusion scans.
99mMIBI scintigraphy was performed following a one-day protocol (stress-rest) in 806 patients (out of them 451 men) with suspected or known coronary artery disease. A bicycle exercise test response was estimated as pathological, non-pathological, borderline and non-informative. Myocardial perfusion was scored according to the size and severity of defect.
Myocardial perfusion was normal in 287 (35.6%) patients. Univariate analysis showed, that normal stress myocardial perfusion scans more often were established in women than in men (p=0.00001, odds ratio 8.55), in patients with atypical anginal or non-anginal chest pain than with typical angina (p=0.0001, odds ratio 1.92), in patients without previous myocardial infarction (p=0.0001, odds ratio 3.28) and without myocardial revascularization (p=0.0001, odds ratio 3.28). The characteristic bicycle exercise test data for normal scans were non-pathological response vs pathological (p=0.00001, odds ratio 3.03) and reason of discontinuance - target heart rate achieved (85% of maximum) vs ischemic changes (p=0.0005, odds ratio 2.37).
Normal stress myocardial perfusion scans were more often present in women, in patients with atypical angina or non-anginal chest pain, in patients without myocardial infarction and without myocardial revascularization. Achieved target heart rate and non-pathological response to exercise test were commonly observed in patients with normal perfusion scans.