Key result
Peripheral arterial disease was associated with a significantly higher rate of reversible perfusion defects on MPS compared to matched controls (24.2% vs 14.0%; P<0.01).
Why the study?
Does the presence of peripheral arterial disease correlate with increased myocardial ischemia assessed by MPS and AECG compared to matched controls?
Case-Control (n=193)
Does the presence of peripheral arterial disease correlate with increased myocardial ischemia assessed by MPS and AECG compared to matched controls?
In patients with peripheral arterial disease, episodes of ST-segment depression on ambulatory ECG often do not correlate with reversible ischemia on myocardial perfusion SPECT, suggesting they may reflect different types of myocardial ischemia.
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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Svensson et al. (2006) conducted a case-control in Peripheral arterial disease (n=193). Peripheral arterial disease vs. No peripheral arterial disease or ischaemic heart disease was evaluated on Reversible perfusion defects in myocardial perfusion SPECT (p=<0.01). Peripheral arterial disease was associated with a significantly higher rate of reversible perfusion defects on MPS compared to matched controls (24.2% vs 14.0%; P<0.01).
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