ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
Larger perfusion defects with exercise compared with dipyridamole SPECT (exercise-dipyridamole mismatch) may reflect differences in epicardial and microvascular coronary dysfunction: when the stressor matters.
Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 20 citations in OpenAlex.
- Epicardial and microvascular coronary vasomotor dysfunction and its relation to myocardial ischemic burden in patients with non-obstructive coronary artery disease.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Article
- Myocardial ischemia without obstructive CAD: there is more than meets the eye!Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018Article
- Feasibility and diagnostic accuracy of exercise treadmill nitrogen-13 ammonia PET myocardial perfusion imaging of obese patients.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2015Article
- Exercise PET: More insight or more complex?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2015Article
- Assessment of coronary blood flow with computed tomography and magnetic resonance imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2010Review
- Noninvasive stress testing of myocardial perfusion defects: head-to-head comparison of thallium-201 SPECT to MRI perfusion.Journal of nuclear cardiology : official publication of the American Society of Nuclear CardiologyArticle
- "Mismatch" in regional myocardial perfusion defects during exercise and pharmacologic vasodilation: a noninvasive marker of epicardial vasomotor dysfunction?Journal of nuclear cardiology : official publication of the American Society of Nuclear CardiologyArticle
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5 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious studies have reported larger myocardial perfusion defects with exercise as compared with dipyridamole. The aim of this study was to assess the hypothesis that this mismatch may reflect differences in epicardial and microvascular coronary vasomotor function. METHODS AND
resultsThe response to intracoronary acetylcholine, nitroglycerin, and adenosine was studied in 36 patients with suspected angina and normal or near-normal coronary angiography findings who underwent both exercise and dipyridamole perfusion imaging. Of the patients, 27 (75%) had reversible defects with exercise (group I) and 9 had normal scans or nonreversible defects (group II). Repeated imaging with dipyridamole showed significant improvement or disappearance of perfusion defects in group I patients. The mean summed difference score (SDS) decreased from 5.52 +/- 3.19 with exercise to 1.11 +/- 1.60 with dipyridamole (P = .0001) in group I and did not change in group II. An abnormal epicardial response to acetylcholine, reflecting endothelial dysfunction, occurred in 93% of group I patients compared with only 33% of group II patients (chi(2) = 9.46, P = .002) and was significantly related to exercise SDS (r = 0.49, P = .002) but not to dipyridamole SDS. By contrast, most patients showed normal epicardial and microvascular responses to the mainly non-endothelium-dependent vasodilators nitroglycerin and adenosine with no differences in coronary flow reserve between groups (2.91 +/- 0.72 vs 2.98 +/- 0.52, P = .79).
conclusionsExercise-dipyridamole perfusion mismatch may reflect differences in epicardial endothelial and microvascular dysfunction.
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