Myocardial ischaemia in patients with peripheral arterial disease
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 i...
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Published in | Clinical physiology and functional imaging Vol. 27; no. 1; pp. 30 - 35 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Oxford, UK
Blackwell Publishing Ltd
01.01.2007
Blackwell Science |
Subjects | |
Online Access | Get full text |
ISSN | 1475-0961 1475-097X |
DOI | 10.1111/j.1475-097X.2007.00710.x |
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Abstract | 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. |
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AbstractList | 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.
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).
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.
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. 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. 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. 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.AIMTo study the relation between myocardial ischemia assessed with different techniques in patients with peripheral arterial disease (PAD) in comparison with a matched control group.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).METHODSNinety-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).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.RESULTSThirteen 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.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.CONCLUSIONMost 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. |
Author | Niklasson, U. De Faire, Ulf Svensson, Per Östergren, Jan |
Author_xml | – sequence: 1 givenname: Per surname: Svensson fullname: Svensson, Per organization: Department of Emergency Medicine – sequence: 2 givenname: Ulf surname: De Faire fullname: De Faire, Ulf organization: Department of Cardiology, Karolinska Hospital – sequence: 3 givenname: U. surname: Niklasson fullname: Niklasson, U. organization: Department of Clinical Physiology, St Görans Hospital, Stockholm, Sweden – sequence: 4 givenname: Jan surname: Östergren fullname: Östergren, Jan organization: Department of Emergency Medicine |
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Keywords | 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 |
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References_xml | – reference: Mahmarian M, John J, Steingart M, Richard M, Forman S, Sharaf M, Barry L. Relation between ambulatory electrocardiographic monitoring and myocardial perfusion imaging to detect coronary artery disease and myocardial ischemia: an ACIP ancillary study. J Am Coll Cardiol (1997); 29: 764-769. – reference: Bone D, Holmgren A, Svane B. Thallium tomography in the detection of myocardial perfusion defects. Acta Med Scand Suppl (1985); 694: 109-119. – reference: Chamuleau SA, Tio RA, De Cock CC, De Muinck ED, Pijls NH, Van Eck-Smit BL, Koch KT, Meuwissen M, Dijkgraaf MG, De Jong A, Verberne HJ, Van Liebergen RA, Laarman GJ, Tijssen JG, Piek JJ. Prognostic value of coronary blood flow velocity and myocardial perfusion in intermediate coronary narrowings and multivessel disease. J Am Coll Cardiol (2002); 39: 852-858. – reference: Crawford MH, Bernstein SJ, Deedwania PC, DiMarco JP, Ferrick KJ, Garson A Jr, Green LA, Greene HL, Silka MJ, Stone PH. ACC/AHA guidelines for ambulatory electrocardiography; A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the Guidelines for Ambulatory Electrocardiography) developed in collaboration with the North American Society for Pacing and Electrophysiology. J Am Coll Cardiol (1999); 34: 912-948. – reference: Goodman SG, Freeman MR, Armstrong PW, Langer A. Does ambulatory monitoring contribute to exercise testing and myocardial perfusion scintigraphy in the prediction of the extent of coronary artery disease in stable angina? Am J Cardiol (1994); 73: 747-752. – reference: McPhail NV, Ruddy TD, Barber GG, Cole CW, Marois LJ, Gulenchyn KY. Cardiac risk stratification using dipyridamole myocardial perfusion imaging and ambulatory ECG monitoring prior to vascular surgery. Eur J Vasc Surg (1993); 7: 151-155. – reference: Quyyumi AA, Panza JA, Diodati JG, Callahan TS, Bonow RO, Epstein SE. 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Aim: To study the relation between myocardial ischemia assessed with different techniques in patients with peripheral arterial disease (PAD) in... Aim: To study the relation between myocardial ischemia assessed with different techniques in patients with peripheral arterial disease (PAD) in comparison... To study the relation between myocardial ischemia assessed with different techniques in patients with peripheral arterial disease (PAD) in comparison with a... |
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SubjectTerms | 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 |
Title | Myocardial ischaemia in patients with peripheral arterial disease |
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