Myocardial perfusion and ventricular function measurements during total coronary artery occlusion in humans

A comparison with rest and exercise radionuclide studies

Salvador Borges-Neto, Joseph Puma, Robert H. Jones, Michael H. Sketch, Richard Stack, Michael W. Hanson, R. Edward Coleman

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: The purpose of this investigation was to compare the magnitude of change in myocardial perfusion and function during exercise with that obtained during total coronary artery occlusion. Radionuclide studies are widely used for the diagnosis and determination of prognosis in patients with suspected or known coronary artery disease. These studies are based on the premise that the relative deficit of coronary blood flow, which is induced by exercise and recognized as increased demand, relates to the jeopardy experienced by the decrease or sudden absolute interruption of coronary blood flow that is recognized as decreased supply and is associated with coronary stenosis or total coronary artery occlusion. The magnitude of exercise- induced perfusion and function abnormalities compared with those induced by total coronary artery occlusion in humans has not been previously reported. Methods and Results: We prospectively studied 20 patients with ≥50% diameter stenosis documented by quantitative coronary angiography in at least one vessel. A same-day rest/exercise sestamibi myocardial function and perfusion study was performed within 24 hours before percutaneous transluminal coronary angioplasty. At 1 minute after balloon inflation, while the vessel was occluded, sestamibi was injected, and a myocardial perfusion and function study was performed. Perfusion defect size was greater during occlusion (28±3%) than during exercise (13±2%) (P<.01). Ejection fraction was greater during exercise (53±3%) compared with values measured during occlusion (41±2%) (P<.01). Conclusions: Physiological abnormalities induced by coronary occlusion are greater than those that occur during exercise, thereby indicating that stress-induced ischemia may not reflect the total potential myocardium in jeopardy from a stenotic lesion, if sudden occlusion occurs.

Original languageEnglish
Pages (from-to)278-284
Number of pages7
JournalCirculation
Volume89
Issue number1
StatePublished - Jan 1 1994
Externally publishedYes

Fingerprint

Ventricular Function
Coronary Occlusion
Radioisotopes
Coronary Vessels
Perfusion
Exercise
Coronary Balloon Angioplasty
Coronary Stenosis
Economic Inflation
Coronary Angiography
Coronary Artery Disease
Myocardium
Pathologic Constriction
Ischemia

Keywords

  • angioplasty
  • coronary disease
  • ischemia
  • sestamibi

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Borges-Neto, S., Puma, J., Jones, R. H., Sketch, M. H., Stack, R., Hanson, M. W., & Coleman, R. E. (1994). Myocardial perfusion and ventricular function measurements during total coronary artery occlusion in humans: A comparison with rest and exercise radionuclide studies. Circulation, 89(1), 278-284.

Myocardial perfusion and ventricular function measurements during total coronary artery occlusion in humans : A comparison with rest and exercise radionuclide studies. / Borges-Neto, Salvador; Puma, Joseph; Jones, Robert H.; Sketch, Michael H.; Stack, Richard; Hanson, Michael W.; Coleman, R. Edward.

In: Circulation, Vol. 89, No. 1, 01.01.1994, p. 278-284.

Research output: Contribution to journalArticle

Borges-Neto, S, Puma, J, Jones, RH, Sketch, MH, Stack, R, Hanson, MW & Coleman, RE 1994, 'Myocardial perfusion and ventricular function measurements during total coronary artery occlusion in humans: A comparison with rest and exercise radionuclide studies', Circulation, vol. 89, no. 1, pp. 278-284.
Borges-Neto, Salvador ; Puma, Joseph ; Jones, Robert H. ; Sketch, Michael H. ; Stack, Richard ; Hanson, Michael W. ; Coleman, R. Edward. / Myocardial perfusion and ventricular function measurements during total coronary artery occlusion in humans : A comparison with rest and exercise radionuclide studies. In: Circulation. 1994 ; Vol. 89, No. 1. pp. 278-284.
@article{5d74f5e5fb824dfd8b59dce8869fe836,
title = "Myocardial perfusion and ventricular function measurements during total coronary artery occlusion in humans: A comparison with rest and exercise radionuclide studies",
abstract = "Background: The purpose of this investigation was to compare the magnitude of change in myocardial perfusion and function during exercise with that obtained during total coronary artery occlusion. Radionuclide studies are widely used for the diagnosis and determination of prognosis in patients with suspected or known coronary artery disease. These studies are based on the premise that the relative deficit of coronary blood flow, which is induced by exercise and recognized as increased demand, relates to the jeopardy experienced by the decrease or sudden absolute interruption of coronary blood flow that is recognized as decreased supply and is associated with coronary stenosis or total coronary artery occlusion. The magnitude of exercise- induced perfusion and function abnormalities compared with those induced by total coronary artery occlusion in humans has not been previously reported. Methods and Results: We prospectively studied 20 patients with ≥50{\%} diameter stenosis documented by quantitative coronary angiography in at least one vessel. A same-day rest/exercise sestamibi myocardial function and perfusion study was performed within 24 hours before percutaneous transluminal coronary angioplasty. At 1 minute after balloon inflation, while the vessel was occluded, sestamibi was injected, and a myocardial perfusion and function study was performed. Perfusion defect size was greater during occlusion (28±3{\%}) than during exercise (13±2{\%}) (P<.01). Ejection fraction was greater during exercise (53±3{\%}) compared with values measured during occlusion (41±2{\%}) (P<.01). Conclusions: Physiological abnormalities induced by coronary occlusion are greater than those that occur during exercise, thereby indicating that stress-induced ischemia may not reflect the total potential myocardium in jeopardy from a stenotic lesion, if sudden occlusion occurs.",
keywords = "angioplasty, coronary disease, ischemia, sestamibi",
author = "Salvador Borges-Neto and Joseph Puma and Jones, {Robert H.} and Sketch, {Michael H.} and Richard Stack and Hanson, {Michael W.} and Coleman, {R. Edward}",
year = "1994",
month = "1",
day = "1",
language = "English",
volume = "89",
pages = "278--284",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Myocardial perfusion and ventricular function measurements during total coronary artery occlusion in humans

T2 - A comparison with rest and exercise radionuclide studies

AU - Borges-Neto, Salvador

AU - Puma, Joseph

AU - Jones, Robert H.

AU - Sketch, Michael H.

AU - Stack, Richard

AU - Hanson, Michael W.

AU - Coleman, R. Edward

PY - 1994/1/1

Y1 - 1994/1/1

N2 - Background: The purpose of this investigation was to compare the magnitude of change in myocardial perfusion and function during exercise with that obtained during total coronary artery occlusion. Radionuclide studies are widely used for the diagnosis and determination of prognosis in patients with suspected or known coronary artery disease. These studies are based on the premise that the relative deficit of coronary blood flow, which is induced by exercise and recognized as increased demand, relates to the jeopardy experienced by the decrease or sudden absolute interruption of coronary blood flow that is recognized as decreased supply and is associated with coronary stenosis or total coronary artery occlusion. The magnitude of exercise- induced perfusion and function abnormalities compared with those induced by total coronary artery occlusion in humans has not been previously reported. Methods and Results: We prospectively studied 20 patients with ≥50% diameter stenosis documented by quantitative coronary angiography in at least one vessel. A same-day rest/exercise sestamibi myocardial function and perfusion study was performed within 24 hours before percutaneous transluminal coronary angioplasty. At 1 minute after balloon inflation, while the vessel was occluded, sestamibi was injected, and a myocardial perfusion and function study was performed. Perfusion defect size was greater during occlusion (28±3%) than during exercise (13±2%) (P<.01). Ejection fraction was greater during exercise (53±3%) compared with values measured during occlusion (41±2%) (P<.01). Conclusions: Physiological abnormalities induced by coronary occlusion are greater than those that occur during exercise, thereby indicating that stress-induced ischemia may not reflect the total potential myocardium in jeopardy from a stenotic lesion, if sudden occlusion occurs.

AB - Background: The purpose of this investigation was to compare the magnitude of change in myocardial perfusion and function during exercise with that obtained during total coronary artery occlusion. Radionuclide studies are widely used for the diagnosis and determination of prognosis in patients with suspected or known coronary artery disease. These studies are based on the premise that the relative deficit of coronary blood flow, which is induced by exercise and recognized as increased demand, relates to the jeopardy experienced by the decrease or sudden absolute interruption of coronary blood flow that is recognized as decreased supply and is associated with coronary stenosis or total coronary artery occlusion. The magnitude of exercise- induced perfusion and function abnormalities compared with those induced by total coronary artery occlusion in humans has not been previously reported. Methods and Results: We prospectively studied 20 patients with ≥50% diameter stenosis documented by quantitative coronary angiography in at least one vessel. A same-day rest/exercise sestamibi myocardial function and perfusion study was performed within 24 hours before percutaneous transluminal coronary angioplasty. At 1 minute after balloon inflation, while the vessel was occluded, sestamibi was injected, and a myocardial perfusion and function study was performed. Perfusion defect size was greater during occlusion (28±3%) than during exercise (13±2%) (P<.01). Ejection fraction was greater during exercise (53±3%) compared with values measured during occlusion (41±2%) (P<.01). Conclusions: Physiological abnormalities induced by coronary occlusion are greater than those that occur during exercise, thereby indicating that stress-induced ischemia may not reflect the total potential myocardium in jeopardy from a stenotic lesion, if sudden occlusion occurs.

KW - angioplasty

KW - coronary disease

KW - ischemia

KW - sestamibi

UR - http://www.scopus.com/inward/record.url?scp=0027979214&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027979214&partnerID=8YFLogxK

M3 - Article

VL - 89

SP - 278

EP - 284

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 1

ER -