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Effect of endothelial dysfunction on regional perfusion in myocardial territories supplied by normal and diseased vessels in patients with coronary artery disease

  • Original Articles
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Endothelium-dependent regulation of coronary tone affects both conduit and resistance coronary arteries. However, little is known about the usefulness of myocardial perfusion imaging in evaluating coronary endothelial function. We evaluated the relation between invasive angiographic measurements of coronary vasomotion in response to intracoronary acetylcholine and the presence of regional perfusion abnormalities assessed by technetium 99m sestamibi imaging.

Methods and Results

We studied 11 patients (9 men and 2 women) with suspected coronary artery disease (48±8 years, mean±standard deviation). We used quantitative coronary angiography to delineate the vasomotor response to increasing doses of acetylcholine given intracoronary. Regional myocardial perfusion was assessed by planar Tc-99m sestamibi imaging during and after the administration of acetylcholine. In the 11 patients, 23 coronary artery territories were analyzed: 13 were angiographically normal, and 10 showed varying degrees of luminal narrowing. Four (31%) of 13 angiographically normal coronary arteries had a positive vasomotor response to acetylcholine (≥20% reduction in luminal diameter) that was associated with a regional perfusion defect. Acetylcholine induced a positive vasomotor response, which was also associated with a regional perfusion defect in 1 of 3 coronary arteries with stenoses of intermediate severity (50% to 69%). Likewise, acetylcholine induced a positive vasomotor response in 6 of 7 coronary arteries with significant luminal narrowing (≥70%), 5 of which showed a corresponding regional perfusion defect.

Conclusions

In patients with coronary artery disease, noninvasive measurements of regional myocardial perfusion by Tc-99m sestamibi correlate well with invasive measurements of coronary endothelial function. These findings may have implications for monitoring the effects of interventions designed to improve endothelial function and microvascular function in patients with coronary artery disease.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, Hospital Cosme Argerich, Buenos Aires, Argentina

    Osvaldo Masoli, Néstor Perez Baliño, Diego Sabaté, Jorge Jalón, Alejandro Meretta, Daniel Cragnolino & Ricardo Sarmiento

  2. Department of Medicine and Radiology, Wayne State University School of Medicine, Detroit, Mich.

    Marcelo F. DiCarli

Authors
  1. Osvaldo Masoli
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  2. Néstor Perez Baliño
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  3. Diego Sabaté
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  4. Jorge Jalón
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  5. Alejandro Meretta
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  6. Daniel Cragnolino
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  7. Ricardo Sarmiento
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  8. Marcelo F. DiCarli
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Corresponding author

Correspondence to Marcelo F. DiCarli.

Additional information

Dr DiCarli is the recipient of a Scientist Development Grant from the American Heart Association, Dallas, Tex.

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Masoli, O., Baliño, N.P., Sabaté, D. et al. Effect of endothelial dysfunction on regional perfusion in myocardial territories supplied by normal and diseased vessels in patients with coronary artery disease. J Nucl Cardiol 7, 199–204 (2000). https://doi.org/10.1016/S1071-3581(00)70007-9

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  • DOI: https://doi.org/10.1016/S1071-3581(00)70007-9

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