Scintigraphic Findings in Patients with Triple-Vessel Coronary Artery Disease

Received 9/8/2002; accepted 10/1/2002. For correspondence or reprints contact: Nan-Jing Peng, M.D., Department of Nuclear Medicine, Kaohsiung Veterans General Hospital. 386 Ta-Chung 1st Road, Kaohsiung 813, Taiwan, ROC. Tel: (886)7-3422121 ext. 6418, Fax: (886)7-3461179, E-mail: [email protected] Background: The scintigraphic findings of triple-vessel coronary artery disease (TVD) may vary from normal to very extensive ones. This investigation is performed to evaluate the perfusion patterns of Tl myocardial perfusion scintigraphy and their relationship with transient ischemic dilation (TID) and increased lung thallium uptake (ILTU) in patients with TVD. Methods: One hundred and eighty-two patients with myocardial perfusion scintigraphy and documented TVD in coronary angiography (CAG) were included. The scintigraphic findings were classified according to the perfusion patterns, and the presence or absence of TID and ILTU. Chi-squared analysis was used to determine the significance of differences between the groups and correlation between TID and ILTU. Results: Thirteen patients (7.1%) had normal perfusion (Group 1), 45 patients (24.7%) had the defects in onevessel territory (Group 2), 84 patients (46.2%) had the defects in combined territories of two vessels (Group 3), and 40 patients (22%) had the defects in the territories of all three vessels (Group 4). The most common perfusion pattern was diffuse perfusion defects except preserved lateral wall (33.5%), and the most common involved area was inferior wall (77.5%). TID was found in 133 patients (73.1%), and ILTU in 38 (20.9%). The presence of TID was significant higher for patients with perfusion defects than those without (P<0.0001). Patients with extensive perfusion defects (in two or more vessels territories) had higher ILTU than those without (P=0.017). Conclusion: Combined assessment of perfusion patterns and associated TID and ILTU help to identify the patients with TVD and evaluate their risk stratification.