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. 2008 Jul;31(7):310-6.
doi: 10.1002/clc.20217.

Coronary vasospasm produces reversible perfusion defects observed during adenosine triphosphate stress myocardial single-photon emission computed tomography

Hiroki Teragawa  1 , Kentaro Ueda, Koichiro Okuhara, Rieko Kuwashima, Yukihiro Fukuda, Masao Kiguchi, Kingo Taniguchi, Yukihito Higashi, Tetsuya Oshima, Masao Yoshizumi, Kazuaki Chayama
Affiliations

Coronary vasospasm produces reversible perfusion defects observed during adenosine triphosphate stress myocardial single-photon emission computed tomography

Hiroki Teragawa et al. Clin Cardiol. 2008 Jul.

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.

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