BACKGROUND: False-negative myocardial perfusion imaging (MPI) can by due to left main (LM) or three-vessel disease causing "balanced ischemia". However, so far prevalence of LM or three-vessel-disease in patients with normal MPI is unclear. We assessed prevalence, location, and extent of significant coronary artery disease (CAD) in patients with normal MPI. METHODS: Between 2006 and 2010, 256 patients with normal MPI who had invasive angiography because of persisting or worsening of the same initial symptoms were studied. Significant CAD was defined as stenosis > 70% or LM > 50%. RESULTS: A total of 93 patients (36%) had significant CAD. Significant CAD was observed more frequently in males, higher age and those with typical angina complaints. Significant LM disease was present in 7%, three-vessel disease in 10%, two-vessel disease in 22%, and single vessel disease (not left main) in 61%. In those with single vessel disease, the location was the LAD in 40%, the RCA in 30%, and the LCX in 30%. CONCLUSIONS: In selected patients with normal MPI, one-third had significant CAD. The majority of these patients had single vessel disease (not left main). LM or three vessel disease, causing "balanced ischemia", is a less common cause of false-negative MPI.
BACKGROUND: False-negative myocardial perfusion imaging (MPI) can by due to left main (LM) or three-vessel disease causing "balanced ischemia". However, so far prevalence of LM or three-vessel-disease in patients with normal MPI is unclear. We assessed prevalence, location, and extent of significant coronary artery disease (CAD) in patients with normal MPI. METHODS: Between 2006 and 2010, 256 patients with normal MPI who had invasive angiography because of persisting or worsening of the same initial symptoms were studied. Significant CAD was defined as stenosis > 70% or LM > 50%. RESULTS: A total of 93 patients (36%) had significant CAD. Significant CAD was observed more frequently in males, higher age and those with typical angina complaints. Significant LM disease was present in 7%, three-vessel disease in 10%, two-vessel disease in 22%, and single vessel disease (not left main) in 61%. In those with single vessel disease, the location was the LAD in 40%, the RCA in 30%, and the LCX in 30%. CONCLUSIONS: In selected patients with normal MPI, one-third had significant CAD. The majority of these patients had single vessel disease (not left main). LM or three vessel disease, causing "balanced ischemia", is a less common cause of false-negative MPI.
Authors: Kees-Joost Botman; Nico H J Pijls; Jan Willem Bech; Wilbert Aarnoudse; Kathinka Peels; Bart van Straten; Olaf Penn; H Rolf Michels; Hans Bonnier; Jacques J Koolen Journal: Catheter Cardiovasc Interv Date: 2004-10 Impact factor: 2.692
Authors: P Y Marie; N Danchin; J F Durand; L Feldmann; A Grentzinger; P Olivier; G Karcher; Y Juillière; J M Virion; D Beurrier Journal: J Am Coll Cardiol Date: 1995-10 Impact factor: 24.094
Authors: D S Berman; H Kiat; J D Friedman; F P Wang; K van Train; L Matzer; J Maddahi; G Germano Journal: J Am Coll Cardiol Date: 1993-11-01 Impact factor: 24.094
Authors: Raymond J Gibbons; Jonathan Abrams; Kanu Chatterjee; Jennifer Daley; Prakash C Deedwania; John S Douglas; T Bruce Ferguson; Stephan D Fihn; Theodore D Fraker; Julius M Gardin; Robert A O'Rourke; Richard C Pasternak; Sankey V Williams; Raymond J Gibbons; Joseph S Alpert; Elliott M Antman; Loren F Hiratzka; Valentin Fuster; David P Faxon; Gabriel Gregoratos; Alice K Jacobs; Sidney C Smith Journal: Circulation Date: 2003-01-07 Impact factor: 29.690