Journal of Nuclear Cardiology

, Volume 21, Issue 3, pp 643–651 | Cite as

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

  • Yohsuke HondaEmail author
  • Takuji Toyama
  • Yuusuke Miyaishi
  • Hakuken Kan
  • Eiji Yamashita
  • Ren Kawaguchi
  • Hitoshi Adachi
  • Hiroshi Hoshizaki
  • Shigeru Oshima
Original Article



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.


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


MIBG imaging coronary spastic angina flow-mediated dilation 





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Copyright information

© American Society of Nuclear Cardiology 2014

Authors and Affiliations

  • Yohsuke Honda
    • 1
    Email author
  • Takuji Toyama
    • 1
  • Yuusuke Miyaishi
    • 1
  • Hakuken Kan
    • 1
  • Eiji Yamashita
    • 1
  • Ren Kawaguchi
    • 1
  • Hitoshi Adachi
    • 1
  • Hiroshi Hoshizaki
    • 1
  • Shigeru Oshima
    • 1
  1. 1.Gunma Prefectural Cardiovascular CenterMaebashiJapan

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