Circulation, Vol 54, 280-288, Copyright © 1976 by American Heart Association
A Maseri, O Parodi, S Severi and A Pesola
In previous studies we demonstrated that variant angina could not be
attributed to increased myocardial demands. In order to investigate whether
a reduction of regional myocardial blood supply could be responsible for
these ischemic episodes, we studied regional myocardial perfusion in six
patients admitted to our coronary care unit. Myocardial scintigrams,
obtained 5-7 min following i.v. injection of 1 mCi of thallium-201,
performed during an episode of ST-segment elevation, showed transmural
deficits of tracer uptake in the heart wall corresponding to the leads
showing ST-segment elevation. These regional deficits ahd disappeared by 2
hours because of late uptake in previously ischemic myocardium. One week
later, following injections performed in the absence of acute ischemia, no
deficit was apparent. Tracer uptake in ischemic areas was 60% to 85% of
that observed a week later. After adjusting for thallium-201 kinetics and
counting geometry promblems., these scintigrams actually represent large
underestimations of actual flow reduction. Thus variant angina appears to
be caused by massive transmural reduction of myocardial blood supply.
ARTICLES
Transient transmural reduction of myocardial blood flow demonstrated by thallium-201 scintigraphy, as a cause of variant angina
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