Relationship of regional myocardial perfusion to segmental wall motion. A physiologic basis for understanding the presence and reversibility of asynergy. [Assessment by /sup 201/Tl scintigraphy]
Experimental work has shown that even small reductions in muocardial perfusion impair contractile performance. We, therefore, studied the relationship between regional perfusion, assessed by thallium-201 scintigraphy and segmental wall motion, quantitated on biplane contrast ventriculograms, in patients with coronary artery disease. We evaluated 270 segments in 54 patients, including 27 without evidence of myocardial infarction. Most normally perfused regions (125 of 140) contracted normally, whereas those with scintigraphic defects at rest were usually asynergic (42 of 46). Surprisingly, 57% (48 of 84) of regions with exercise-induced perfusion defects were also asynergic, including 48% (25 of 52) of those in patients without myocardial infarction. In 22 patients who had intervention ventriculograms, improvement of perfusion abnormalities at rest correlated closely with reversibility of asynergy. Although there was an association between the location and severity of coronary artery stenosis and segmental wall motion, myocardial perfusion during exercise was a significantly better predictor of asynergy. These findings suggest that resting asynergy may occur even in patients without previous infarction, predominantly in regions with jeopardized perfusion. Asynergy in regions with exercise-induced perfusion abnormalities may, therefore, be an indicator of resting ischemia and may be reversible by coronary artery revascularization.
- Research Organization:
- Univ. of California, San Francisco
- OSTI ID:
- 6470518
- Journal Information:
- Circulation; (United States), Journal Name: Circulation; (United States) Vol. 58:6; ISSN CIRCA
- Country of Publication:
- United States
- Language:
- English
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59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
ANEMIAS
BETA DECAY RADIOISOTOPES
BIOLOGICAL FUNCTIONS
BIOLOGICAL STRESS
BIOMEDICAL RADIOGRAPHY
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CORRELATIONS
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
DYNAMIC FUNCTION STUDIES
ELECTRON CAPTURE RADIOISOTOPES
HEART
HEAVY NUCLEI
HEMIC DISEASES
ISCHEMIA
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MEDICINE
MUSCLES
MYOCARDIUM
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATIENTS
PERFUSED TISSUES
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIOLOGY
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
SYMPTOMS
THALLIUM 201
THALLIUM ISOTOPES
TISSUES