Detection of coronary vasospasm by posthyperventilation technetium-99m sestamibi single-photon emission computed tomography imaging in patients with coronary artery disease. 1998

H Shanoudy, and P Raggi, and C Gasperetti, and A Soliman, and K Ramachandran, and G E Ammerman, and D C Russell
Cardiology Section, Department of Veterans Affairs Medical Center, Salem, Virginia, USA.

Forced hyperventilation is simple, safe to perform, and can be used as a provocative test for coronary vasospasm. This study assesses whether a vasospastic component of angina might be detected in patients with angiographically "nonobstructive" coronary artery disease by posthyperventilation technetium-99m (Tc-99m) sestamibi single-photon emission computed tomography (SPECT) cardiac imaging. Eleven patients with angiographically nonobstructive coronary artery disease underwent Tc-99m sestamibi SPECT imaging at rest and after forced hyperventilation. Vessel diameters were measured by quantitative angiography before and after forced hyperventilation, and posthyperventilation SPECT images were compared with dipyridamole Tc-99m sestamibi stress images. Forced hyperventilation resulted in a 15% reduction in coronary artery diameter in stenotic segments (p <0.01), and a 17% reduction in adjacent nonstenotic segments (p <0.001). Myocardial uptake of Tc-99m sestamibi in segments perfused by vessels with angiographically nonobstructive stenoses was reduced by 24% following forced hyperventilation (p <0.001) compared with only 4% following dipyridamole (p <0.02). These findings suggest that posthyperventilation Tc-99m sestamibi SPECT imaging in patients with angina pectoris and nonobstructive coronary artery disease may be useful in identifying a vasospastic component of angina.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D003329 Coronary Vasospasm Spasm of the large- or medium-sized coronary arteries. Coronary Artery Spasm,Coronary Artery Vasospasm,Artery Spasm, Coronary,Artery Vasospasm, Coronary,Coronary Artery Spasms,Coronary Artery Vasospasms,Coronary Vasospasms,Spasm, Coronary Artery,Vasospasm, Coronary,Vasospasm, Coronary Artery
D006334 Heart Function Tests Examinations used to diagnose and treat heart conditions. Cardiac Function Tests,Cardiac Function Test,Function Test, Cardiac,Function Test, Heart,Function Tests, Cardiac,Function Tests, Heart,Heart Function Test,Test, Cardiac Function,Test, Heart Function,Tests, Cardiac Function,Tests, Heart Function
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000787 Angina Pectoris The symptom of paroxysmal pain consequent to MYOCARDIAL ISCHEMIA usually of distinctive character, location and radiation. It is thought to be provoked by a transient stressful situation during which the oxygen requirements of the MYOCARDIUM exceed that supplied by the CORONARY CIRCULATION. Angor Pectoris,Stenocardia,Stenocardias
D015899 Tomography, Emission-Computed, Single-Photon A method of computed tomography that uses radionuclides which emit a single photon of a given energy. The camera is rotated 180 or 360 degrees around the patient to capture images at multiple positions along the arc. The computer is then used to reconstruct the transaxial, sagittal, and coronal images from the 3-dimensional distribution of radionuclides in the organ. The advantages of SPECT are that it can be used to observe biochemical and physiological processes as well as size and volume of the organ. The disadvantage is that, unlike positron-emission tomography where the positron-electron annihilation results in the emission of 2 photons at 180 degrees from each other, SPECT requires physical collimation to line up the photons, which results in the loss of many available photons and hence degrades the image. CAT Scan, Single-Photon Emission,CT Scan, Single-Photon Emission,Radionuclide Tomography, Single-Photon Emission-Computed,SPECT,Single-Photon Emission-Computed Tomography,Tomography, Single-Photon, Emission-Computed,Single-Photon Emission CT Scan,Single-Photon Emission Computer-Assisted Tomography,Single-Photon Emission Computerized Tomography,CAT Scan, Single Photon Emission,CT Scan, Single Photon Emission,Emission-Computed Tomography, Single-Photon,Radionuclide Tomography, Single Photon Emission Computed,Single Photon Emission CT Scan,Single Photon Emission Computed Tomography,Single Photon Emission Computer Assisted Tomography,Single Photon Emission Computerized Tomography,Tomography, Single-Photon Emission-Computed
D017023 Coronary Angiography Radiography of the vascular system of the heart muscle after injection of a contrast medium. Angiography, Coronary,Angiographies, Coronary,Coronary Angiographies
D017256 Technetium Tc 99m Sestamibi A technetium imaging agent used to reveal blood-starved cardiac tissue during a heart attack. 99mTc-Hexamibi,99mTc-Sestamibi,Tc MIBI,Cardiolite,Tc-99m-Methoxy-2-isobutylisonitrile,Technetium Tc 99m 2-Methoxy-2-methylpropylisonitrile,Technetium Tc 99m Sestamibi Chloride,Technetium-99m-Hexamibi,Technetium-99m-Sestamibi,99mTc Hexamibi,99mTc Sestamibi,Tc 99m Methoxy 2 isobutylisonitrile,Technetium 99m Hexamibi,Technetium 99m Sestamibi,Technetium Tc 99m 2 Methoxy 2 methylpropylisonitrile
D019275 Radiopharmaceuticals Compounds that are used in medicine as sources of radiation for radiotherapy and for diagnostic purposes. They have numerous uses in research and industry. (Martindale, The Extra Pharmacopoeia, 30th ed, p1161) Radiopharmaceutical

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