BACKGROUND: The combination of angina pectoris, angiographically normal coronary arteries, and a positive exercise stress test (EST) is referred to as cardiac syndrome X. However, a large group of patients suspected of syndrome X reveals a normal exercise stress test and weakens the diagnosis of syndrome X. Previous studies demonstrated an impaired coronary flow reserve on ammonia positron emission tomography (PET) in patients with syndrome X. AIM: To evaluate the coronary flow reserve in patients suspected of syndrome X with positive and negative EST findings, using [(13)N]ammonia PET as the diagnostic aid. METHODS: Forty-two patients with chest pain and a normal coronary angiography, were analysed by exercise stress testing (EST) and the dypyridamole stress test (DST) on [(13)N]ammonia PET. Two subgroups were predefined, based on outcome of EST: an EST positive and negative group. A normal control group was used as the reference method. RESULTS: A total of 24 (57%) out of 42 patients had significant ST-T changes (EST positive). [(13)N]ammonia PET showed a significantly lower rest flow in the EST positive and EST negative group compared to controls (P<0.001 and P=0.0028, respectively). DST [(13)N]ammonia PET perfusion was significantly reduced in flow in both the EST positive and EST negative groups (P<0.001 both), as was the DST/rest [(13)N]ammonia perfusion reserve (P<0.001 for both), compared to normal controls. CONCLUSION: PET demonstrates a reduced coronary flow reserve in patients suspected of syndrome X, irrespective of the EST findings.
BACKGROUND: The combination of angina pectoris, angiographically normal coronary arteries, and a positive exercise stress test (EST) is referred to as cardiac syndrome X. However, a large group of patients suspected of syndrome X reveals a normal exercise stress test and weakens the diagnosis of syndrome X. Previous studies demonstrated an impaired coronary flow reserve on ammonia positron emission tomography (PET) in patients with syndrome X. AIM: To evaluate the coronary flow reserve in patients suspected of syndrome X with positive and negative EST findings, using [(13)N]ammonia PET as the diagnostic aid. METHODS: Forty-two patients with chest pain and a normal coronary angiography, were analysed by exercise stress testing (EST) and the dypyridamole stress test (DST) on [(13)N]ammonia PET. Two subgroups were predefined, based on outcome of EST: an EST positive and negative group. A normal control group was used as the reference method. RESULTS: A total of 24 (57%) out of 42 patients had significant ST-T changes (EST positive). [(13)N]ammonia PET showed a significantly lower rest flow in the EST positive and EST negative group compared to controls (P<0.001 and P=0.0028, respectively). DST [(13)N]ammonia PET perfusion was significantly reduced in flow in both the EST positive and EST negative groups (P<0.001 both), as was the DST/rest [(13)N]ammonia perfusion reserve (P<0.001 for both), compared to normal controls. CONCLUSION: PET demonstrates a reduced coronary flow reserve in patients suspected of syndrome X, irrespective of the EST findings.
Authors: R A Tio; R H J A Slart; R A de Boer; P A van der Vleuten; R M de Jong; L M van Wijk; T Willems; D D Lubbers; A A Voors; D J van Veldhuisen Journal: Neth Heart J Date: 2009-12 Impact factor: 2.380
Authors: I A C Vermeltfoort; P G H M Raijmakers; I I Riphagen; D A M Odekerken; A F M Kuijper; A Zwijnenburg; G J J Teule Journal: Clin Res Cardiol Date: 2010-04-21 Impact factor: 5.460
Authors: I A C Vermeltfoort; P G H M Raijmakers; D A M Odekerken; A F M Kuijper; A Zwijnenburg; G J J Teule Journal: J Nucl Cardiol Date: 2009-01-22 Impact factor: 5.952
Authors: Camilla Astley; Maria Fernanda Badue Pereira; Marcos Santos Lima; Carlos Alberto Buchpiguel; Camila G Carneiro; Marcelo Tatit Sapienza; Gabriela Nunes Leal; Danilo Marcelo Leite do Prado; Tiago Peçanha; Sofia Mendes Sieczkowska; Olivia Mari Matsuo; Livia Lindoso; Heloisa Helena Marques; Clovis Artur Silva; Bruno Gualano Journal: Physiol Rep Date: 2022-03