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Chest Pain with Normal Coronary Angiograms: Pathogenesis, Diagnosis and Management pp 181–185Cite as

Imaging in Microvascular Angina - What’s New ?

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Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 213))

Abstract

Normal or near normal coronary arteriography is a prerequisite for the diagnosis of microvascular angina. However it is often forgotten that arteriography provides merely a luminogram of the artery. This is exemplified by the demonstration of fibrous or lipid containing plaques within the artery wall using intracoronary ultrasound and Doppler, which may escape detection by contrast arteriography, particularly when located at the coronary ostium [1].

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References

  1. Essop AR, Scott PJ, Tweddel AC et al. The surgical implications of intraluminal coronary ultrasound. Am Heart J 1993;25:882–4.

    Article  Google Scholar 

  2. Erbel R, Ge J, Bockisch A et al. Value of intra coronary ultrasound and Doppler in the differentiation of angiographically normal coronary arteries. Eur Heart J 1996; 17:880–889.

    Article  PubMed  CAS  Google Scholar 

  3. Kemp HG. Left ventricular function in patients with anginal syndrome and normal coronary arteriograms. Am J Cardiol 1973; 32:375–6.

    Article  PubMed  Google Scholar 

  4. Wilson RF, White CW. Intracoronary papaverine: an ideal coronary vasodilator for studies of the coronary circulation in conscious humans. Circulation 1986; 73:444–51.

    Article  PubMed  CAS  Google Scholar 

  5. McGinn AL, White CW, Wilson RF. Interstudy variability of coronary vasdilator reserve: influence of heart rate, arterial presure and ventricular preload. Circulation 1990; 81:1319–30.

    Article  PubMed  CAS  Google Scholar 

  6. Opherk D, Zebe H, Schuler G, Weihe E, Mall G, Kubler W. Reduced coronary reserve and abnormal exercise left ventricular reserve in patients with syndrome X. Arch Mal Coeur 1983; 76: 231–235.

    PubMed  Google Scholar 

  7. Yokoyama I, Ohtake T, Monomura S-I et al. Reduced coronary flow reserve in hypercholesterolemic patients without overt coronary stenosis. Circulation 1996; 94:3232–3238.

    Article  PubMed  CAS  Google Scholar 

  8. Uren NG, Marraccini P, Gistri R, de Silva R, Camici PG. Altered coronary vasdilator reserve and metabolism in myocardium subtended by normal arteries in patients with coronary artery disease. J Am Coll Cardiol 1993; 22:650–8.

    Article  PubMed  CAS  Google Scholar 

  9. Kern MJ, Bach RG, Mechem CJ et al. Variations in normal coronary vasodilator reserve stratified by artery, gender, heart transplantation and coronary artery disease. JACC 1996; 28:1154–60.

    PubMed  CAS  Google Scholar 

  10. Puskas C, Kosch M, Kerber S et al. Progressive heterogeneity of myocardial perfusion in heart transplant recipients detected by Thallium-201 myocardial SPECT. J Nucl Med 1997; 38:760–5.

    PubMed  CAS  Google Scholar 

  11. Cannon R, Epstein SE. “Microvascular angina” as a cause of chest pain with angiographically normal coronary arteries. Am J Cardiol 1988; 61:1338–1343.

    Article  PubMed  Google Scholar 

  12. Tweddel AC, Martin W. Myocardial perfusion imaging with Xenon-133. In What’s New in Cardiac Imaging? Ed EE van der Wall Kluwer Academic Publishers 1992; 41–48.

    Google Scholar 

  13. Elson SH, Clark WS, Williams BR. Is `diaphragmatic ` attenuation a misnomer? Int J Card 1997; 130:161–64.

    Google Scholar 

  14. Prvulovich EM, Lonn AHR, Bomanji JB et al. Transmission scanning for attenuation correction of myocardial 201 T1 images in obese patients. Nucl Med Commun 1997; 18:207–218.

    Article  PubMed  CAS  Google Scholar 

  15. Bartlett ML, Bacharach SL, Voipio-Pulkki LM, Dilsizian V. Artifactual inhomogeneities in Myocardial PET and SPECT scans in normal subjects. J Nuc Med 1995: 36:188–195.

    CAS  Google Scholar 

  16. Canty JM, Klocke FJ. Reduced myocardial perfusion in the presence of pharmacologic vasodilator reserve. Circulation 1985;71:370–377.

    Article  PubMed  Google Scholar 

  17. Berger BC, Abramowitz R, Park CH et al. Abnormal thallium-201 scans in patients with chest pain and angiographically normal coronary arteries. Am J Cardiol 1983; 52:365–370.

    Article  PubMed  CAS  Google Scholar 

  18. Tweddel AC, Martin W, Hutton I. Thallium scans in Syndrome X. Br Heart J 1992; 68:48–50.

    Article  PubMed  CAS  Google Scholar 

  19. Kao CH, Weng SJ, Ting CT, Chen YT. Thallium 201 myocardial SPET in strictly defined Syndrome X. Nucl Med Commun 1995; 16:640–646.

    Article  PubMed  CAS  Google Scholar 

  20. Tweddel AC, Jones EA, Evans W et al. Vascular or myocardial abnormality in microvascular angina: Thallium and Technetium perfusion imaging compared. Heart 1996; 75:54.

    Google Scholar 

  21. Cesar LA, Ramires JA, Serrano CV et al. Slow coronary mn-off in patients with angina pectoris: clinical significance and thallium -201 scintigraphic study. Braz J Med Biol Res 1996; 29:(5) 605–13.

    PubMed  CAS  Google Scholar 

  22. Ciavolella M, Avella A, Bellagamba S et al. Angina and normal epicardial coronary arteries: radionuclide features and pathophysiological implications at long term follow-up. Cor Art Dis 1994; 5:493–99.

    CAS  Google Scholar 

  23. Marcus ML, Chillian WM, Kanatsuka H et al. Understanding the coronary circulation through studies at the microvascular level Circulation 1990; 82:1–7.

    CAS  Google Scholar 

  24. Galassi AR, Crea F, Araujo LI et al. Comparison of regional myocardial blood flow in Syndrome X and one vessel coronary disease. Am J Cardiol 1993; 72:(2) 134.

    Article  PubMed  CAS  Google Scholar 

  25. Meer JG, Blanksma PK, Crijns HJG. Mechanisms of angina pectoris in Syndrome X assessed by myocardial perfusion dynamics and heart rate variability. Eur Heart J 1995; 16 1571–7.

    Google Scholar 

  26. Cannon RO, Bonow RO, Bacharach SL et al. Left ventricular dysfunction in patients with angina pectoris, normal epicardiac coronary arteries and abnormal vasodilator reserve. Circulation 1985; 71:218–26.

    Article  PubMed  Google Scholar 

  27. Legrand V, Hodgson J, Bates E et al. Abnormal coronary flow reserve and abnormal radionuclide exercise test result in patients with normal coronary arteriograms. J Am Coll Cardiol 1985; 6:1245–53.

    Article  PubMed  CAS  Google Scholar 

  28. Panza JA, Laurienzo JM, Curiel RV et al. Investigation of the mechanism of chest pain in patients with angiographically normal coronary arteries using transesophageal dobutamine stress echocardiography. J Am Coll Cardiol 1997; 29:293–301.

    Article  PubMed  CAS  Google Scholar 

  29. Nihoyannopoulos P, Kaski JC, Crake T, Maseri A. Absence of myocardial dysfunction during stress in patients with syndrome X. J Am Coll Cardiol 1991; 18:1463–70.

    Article  PubMed  CAS  Google Scholar 

  30. Gould KL. Why Angina Pectoris in aortic stenosis. Circulation 1997; 95:790–2.

    Article  PubMed  CAS  Google Scholar 

  31. Inobe Y, Kugiyama K, Morita E et al. Role of adenosine in pathogenesis of syndrome X: assessment with coronary hemodynamic measurements and Thallium-201 myocardial Single -Photon Emission Computed Tomography. JACC 1996; 28:890–6.

    PubMed  CAS  Google Scholar 

  32. Hundley WG, Lange RA, Clarke GD et al. Assessment of coronary arterial flow reserve in humans with magnetic resonance imaging. Circulation 1996; 93:(8) 1502–8.

    Article  PubMed  CAS  Google Scholar 

  33. Wilke N, Jerosch-Herold M, Wang Y et al. Myocardial perfusion reserve: Assessment with multisection, quantitative first -pass MR imaging. Radiology 1997; 204:373–384.

    PubMed  CAS  Google Scholar 

  34. Kone BC. A ‘BOLD’ new approach to renal oxygen economy. Circulation 1996; 94:3067–68.

    Article  PubMed  CAS  Google Scholar 

  35. Li D, Dhawale P, Rubin PJ et al. Myocardial signal response to dipyridamole and dobutamine: demonstration of the BOLD effect using a double -echo gradient-echo sequence. Magn Res Med 1996; 36:16–20.

    Article  CAS  Google Scholar 

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Authors
  1. Ann Tweddel
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Editors and Affiliations

  1. St George’s Hospital Medical School, London, UK

    Juan Carlos Kaski MD, MRCP, FACC, FESC (BHF Sugden Reader in Clinical Cardiology and Consultant Cardiologist, Head of Coronary Artery Disease Research Group) (BHF Sugden Reader in Clinical Cardiology and Consultant Cardiologist, Head of Coronary Artery Disease Research Group)

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© 1999 Springer Science+Business Media New York

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Tweddel, A. (1999). Imaging in Microvascular Angina - What’s New ?. In: Kaski, J.C. (eds) Chest Pain with Normal Coronary Angiograms: Pathogenesis, Diagnosis and Management. Developments in Cardiovascular Medicine, vol 213. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5181-2_17

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  • DOI: https://doi.org/10.1007/978-1-4615-5181-2_17

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-7360-5

  • Online ISBN: 978-1-4615-5181-2

  • eBook Packages: Springer Book Archive

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