Congress:
16th EUROPEAN CONFERENCE OF THE INTERNATIONAL
SOCIETY OF NON-INVASIVE CARDIOLOGY
Sveti Stefan.Montenegro,Yu.1997.
Estimation of Coronary Arteries and myocardial
scintigraphy with 201 Tl in
Patients with complete branch block and anginal discomforts
Zivojin Stamenkovic et al.
University Clinic of Cardiology,Institute of Cardiovascular Diseases,
Sremska Kamenica,Novi Sad,Yu.
Introdiction: The study involved 28 pts with LBBB,aged 38-63,who visited their
cardiologist because of anginal discofort,particulary during exercise.Coronary
angiography was perfomed in 20 pts with severe angina pain.The find findings of
coronary angiography were normal in 12 pts.In 8 of the 12 normal
myocardialscintigraphy was found.LAD changes were detected in 6 pts.Defect in Tl
201 fixation was septal and anteroseptal.The defect was irreversibile in 6
pts.Radionuclide
Equilibrium ventriculography with phase in the study group pointed to asynchrony
in heart contraction because of a delay in contraction of the anteroseptal
region. This finding
Pointed to myocardial ischemia despite normal findings of coronary angiography.
It was
Believed that this “functional ischemia” was a sequela of prolonged compression
on
Septal arteries by asynchronous septal contraction and augmented blood pressure
on the walls of the left ventricle in its outflow tract.
Resilts: Localisation of the defect was septal (S),anterior (A) or
anterior-septal (AS) in 2o pts,while it was posterior-lateral (PL) in 1 pts. In
6 pts TL 201 fixation defest was irreversibile (NR).However,8 pts with severe
anginal discomforts,particulary during exercise,had normal findings on coronary
angiography while the finding from Tl 201
Myocardial scintigraphy was considerably pathologic.The defect was located in
the
S region of five pts and in the AS region of three.
Conclusion:Why is anteroseptal ischemia is registered in spit of the normal
coronary angiography finding?We are of the opinion that this functional ischemia
(still hypothetical) is the result of prolonged septal artery compression due to
asynchronous septal contraction.The precise mechanism for septal redistribution
of Tl 201 in pts
With LVBB and normal coronary arteries is unknown and warrants further
investigation.
Oral presentasions
Prof. Dr.Z.Stamenkovic, Chairman of the 16th European Conference of the ISNC
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