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Combination of 123I-metaiodobenzylguanidine scintigraphy and flow-mediated dilation for the detection of patients with coronary spastic angina

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

This study evaluated the usefulness of cardiac sympathetic nerve activity, estimated by 123I-MIBG scintigraphy, and endothelial function, estimated by flow-mediated dilation (FMD), in the detection of coronary spastic angina (CSA).

Methods and results

We compared 78 consecutive patients suspected of CSA with ten age-matched controls. On the basis of a spasm provocation test with acetylcholine, 53 patients were diagnosed as CSA and 25 patients were considered to have chest-pain syndrome (CPS). The total defect score (TDS) by delayed 123I-MIBG scintigraphy was significantly higher in both patient groups than in controls (P < 0.05), and was significantly higher in CSA than in CPS patients (P = 0.02). The heart/mediastinum activity (H/M) ratio by delayed 123I-MIBG scintigraphy and FMD were significantly lower in both patient groups than in controls (P < 0.05), and were lower in CSA than in CPS patients (P = 0.04). In receiver-operating curve analysis, the areas under the curve for TDS, H/M, and FMD were 0.78, 0.72, and 0.70, respectively. The combination of delayed 123I-MIBG scintigraphy and FMD showed a higher diagnostic value than either method alone.

Conclusions

123I-MIBG scintigraphy and FMD can distinguish CSA patients among patients complaining of chest pain at rest, with good sensitivity and specificity.

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Authors and Affiliations

  1. Gunma Prefectural Cardiovascular Center, 3-12, Kameizumi-machi, Maebashi, Gunma, 371-0004, Japan

    Yohsuke Honda MD, Takuji Toyama MD, Yuusuke Miyaishi MD, Hakuken Kan MD, Eiji Yamashita MD, Ren Kawaguchi MD, Hitoshi Adachi MD, Hiroshi Hoshizaki MD & Shigeru Oshima MD

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  1. Yohsuke Honda MD
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  2. Takuji Toyama MD
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  3. Yuusuke Miyaishi MD
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  4. Hakuken Kan MD
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  5. Eiji Yamashita MD
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  6. Ren Kawaguchi MD
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  7. Hitoshi Adachi MD
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  8. Hiroshi Hoshizaki MD
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  9. Shigeru Oshima MD
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Correspondence to Yohsuke Honda MD.

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Honda, Y., Toyama, T., Miyaishi, Y. et al. Combination of 123I-metaiodobenzylguanidine scintigraphy and flow-mediated dilation for the detection of patients with coronary spastic angina. J. Nucl. Cardiol. 21, 643–651 (2014). https://doi.org/10.1007/s12350-014-9859-7

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  • DOI: https://doi.org/10.1007/s12350-014-9859-7

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