High incidence of scintigraphic myocardial uptake defects at rest and during exercise in male elite runners.

OBJECTIVE To evaluate the usefulness of myocardial perfusion scintigraphy (MIBI-SPECT) as a diagnostic tool in well trained men. DESIGN The study was prospective, involving 2 d stress-rest myocardial scintigraphy (MIBI-SPECT), polar map reconstruction with and without uniform attenuation correction, and comparison with a healthy male group (local Swedish) and with a commonly used reference group (American, Emory University Hospital). SETTING University Hospital, Stockholm, Sweden. SUBJECTS 16 healthy, male elite runners (mean (SD) age 26.1 (3.1) years). Peak oxygen uptake 73 (4) ml O2/kg/min. RESULTS Uptake defects on polar maps were found in the majority of the runners compared with both reference groups (local Swedish 13/16, American 10/16). Most defects (91%) were fixed. Defects were located in the anterior, lateral, and posterior regions of the left ventricle. Application of a uniform attenuation correction algorithm enhanced rather than reduced perfusion defect size, probably because this correction method is imperfect in SPECT studies of the thoracic cavity. CONCLUSIONS If myocardial perfusion scintigraphy is used for evaluating well trained men, existing normal reference files for semiquantitative evaluation appear to be inadequate.