Heart and Vessels

, Volume 7, Supplement 1, pp 106–110 | Cite as

Coronary arterial involvement in aortitis syndrome: Assessment by exercise thallium scintigraphy

  • Tsunehiko Nishimura
  • Toshiisa Uehara
  • Kohei Hayashida
  • Takahiro Kozuka
Article

Summary

It is important in patient management to evaluate coronary arterial involvement in aortitis syndrome. Twenty-one cases of aortitis syndrome who experienced chest pain were examined using exercise thallium scintigraphy. The patients were divided into 4 groups according to the angiographic findings. There were five patients with left main coronary arterial involvement (group A), four with left or right coronary arterial involvement (group B), nine with aortic regurgitation (group C), and three with pulmonary arterial involvement (group D). In groups A and B, all patients had positive ECGs and thallium perfusion defects. Group A patients showed extensive anterolateral perfusion defects, which were compatible with left main coronary arterial involvement. Groups C and D patients, who had normal coronary arteries, showed no remarkable perfusion defects although five had positive ECG findings. Thus, the sensitivity and specificity of exercise scintigraphy for detection of myocardial ischemia were 9/9 and 12/12, while those of stress ECG were 9/9 and 7/12 (58%), respectively. It is recommended that exercise thallium scintigraphy be used for detecting cllinically occult but significant coronary arterial involvement in aortitis syndrome with chest pain.

Key words

Aortitis syndrome Exercise thallium scintigraphy Left main coronary artery disease 

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References

  1. 1.
    Judge RD, Currier RD, Gracie WA, Figley MM (1962) Takayasu's arteritis and the aortic arch syndrome. Am J Med 32:379–392PubMedGoogle Scholar
  2. 2.
    Nakao K, Ideda M, Kimata S, Nitani H, Miyahara M, Ishimi Z, Hashiba K, Takeda Y, Ozawa T, Matsushita T, Kuramochi M (1967) Takayasu's arteritis, clinical reports of eighty-four cases and immunological studies of seven cases. Circulation 35:1141–1155PubMedGoogle Scholar
  3. 3.
    Kozuka T, Nosaki T (1969) Aortic insufficiency as a complication of the aortitis syndrome. Acta Radiol 8:49–53Google Scholar
  4. 4.
    Kozuka T, Nosaki T, Sato K, Ihara K (1967) Aortitis syndrome with with special reference to pulmonary vascular changes. Acta Radiol 7:25–32Google Scholar
  5. 5.
    Ishikawa K (1978) Natural history and classification of occlusive thromboaortopathy (Takayasu's Disease). Circulation 57:27–35PubMedGoogle Scholar
  6. 6.
    Ishikawa K (1981) Survival and morbidity after diagnosis of occlusive thromboaortopathy (Takayasu's Disease). Am J Cardiol 47:1026–1032PubMedGoogle Scholar
  7. 7.
    Young JA, Sengupta A, Khanja F (1973) Coronary arterial stenosis, angina pectoris and a typical coactation of the aorta due to non-specific arteritis. Am J Cardiol 32:356–360PubMedGoogle Scholar
  8. 8.
    Cipriano PR (1977) Coronary arterial narrowing in Takayasu's aortitis. Am J Cardiol 39:744–750PubMedGoogle Scholar
  9. 9.
    Dash H, Massie BM, Botvinick EH, Brundge BH (1979) The noninvasive identification of left main and three vessel coronary artery disease by myocardial stress perfusion scintigraphy and treadmill exercise electrocardiography. Circulation 60:276–284PubMedGoogle Scholar
  10. 10.
    Lupi-Herrera E, Sanchez-Torres G, Marcushamer J, Mispireta J, Horwitz S, Vela JE (1977) Takayasu's arteritis. Clinical study of 107 cases. Am Heart J 93:94–103PubMedGoogle Scholar
  11. 11.
    Saito Y, Hirota K, Ito I (1972) Clinical and pathologic studies five autopsied cases aortitis syndrome. Jpn Heart J 13:107–117PubMedGoogle Scholar
  12. 12.
    Morooka S, Saito Y, Nonaka Y, Gyotoku Y, Sugimoto T (1984) Clinical features and course of aortitis syndrome in Japanese women older than 40 years. Am J Cardiol 53:859–861PubMedGoogle Scholar
  13. 13.
    Colby J, Hakki A, Iskandrian AS, Mattleman S (1983) Hemodynamic, angiographic and scintigraphic correlates of positive exercise electrocardiograms. Emphasis of strongly positive exercise electrogram. J Am Coll Cardiol 2:21–29PubMedGoogle Scholar
  14. 14.
    Nitenberg A, Foult JM, Antony I, Blanchet T, Rahali M (1988) Coronary flow and resistance reserve in patients with chronic aortic regurgitation, angina pectoris and normal coronary artieries. J Am Coll Cardiol 11:478–493PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • Tsunehiko Nishimura
    • 1
    • 2
  • Toshiisa Uehara
    • 1
  • Kohei Hayashida
    • 1
  • Takahiro Kozuka
    • 2
  1. 1.Department of RadiologyNational Cardiovascular Center 5-7-1 FujishirodaiSuita, OsakaJapan
  2. 2.Department of RadiologyOsaka University, School of MedicineJapan

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