Myocardial ischaemia in patients with peripheral arterial disease

• Published in: Clinical physiology and functional imaging Vol. 27; no. 1; pp. 30 - 35
• Main Authors: Svensson, Per, De Faire, Ulf, Niklasson, U., Östergren, Jan
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.01.2007; Blackwell Science
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Electrocardiography - methods; electrocardiography ambulatory; Exercise Test; exercise testing and exercise physiology; Female; Fundamental and applied biological sciences. Psychology; general clinical cardiology; Humans; imaging/nuclear cardiology; ischaemic heart disease/pathophysiology; Male; Middle Aged; Myocardial Ischemia - complications; Myocardial Ischemia - diagnosis; peripheral vascular disease; Peripheral Vascular Diseases - complications; Peripheral Vascular Diseases - diagnosis; Risk Assessment - methods; Risk Factors; Tomography, Emission-Computed, Single-Photon - methods; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Physical exercise; Human; Pathophysiology; Cardiovascular disease; Myocardial ischemia; Coronary heart disease; Myocardial disease; peripheral vascular disease; Arterial disease; Vascular disease; ischaemic heart disease/pathophysiology; Vertebrata; Mammalia; electrocardiography ambulatory; Imaging; exercise testing and exercise physiology; Electrocardiography; Occlusive arterial disease; imaging/nuclear cardiology; general clinical cardiology
• ISSN: 1475-0961; 1475-097X
• DOI: 10.1111/j.1475-097X.2007.00710.x

Summary Aim:  To study the relation between myocardial ischemia assessed with different techniques in patients with peripheral arterial disease (PAD) in comparison with a matched control group. Methods:  Ninety‐nine male patients with PAD and 94 age‐ and sex‐matched control subjects without PAD or ischaemic heart disease performed a exercise treadmill test, dipyridamole Tc‐99m sestamibi myocardial perfusion SPECT (MPS) (43 controls) and 48‐h ambulatory ECG (AECG)‐monitoring (43 controls). Results:  Thirteen of 99 patients had irreversible and 24 of 99 had reversible perfusion defects in MPS in comparison with 0 of 43 and six of 43 of control subjects respectively (P<0·01). Thirteen of 84 evaluable patients experienced a total of 36 episodes of ST‐depression in AECG in comparison with two episodes in two of 42 control subjects (P = 0·07). Out of 13 patients with ST‐depression episodes only three had reversible ischaemia in MPS. Conclusion:  Most PAD patients with episodes of ST‐segment depression have no reversible ischaemia as assessed with dipyridamole‐stress MPS. Episodes of ST‐segment depression may reflect types of myocardial ischaemia that are different from those detected by MPS.