Hypertensive patients with false-positive Thallium-201 scintigraphic results in the infero-posterior wall are in high risk for coronary artery disease development

Abstract Background It has been previously postulated that Thallium-201 (Tl201 ) scintigraphy is characterized by relatively low specificity in hypertensive patients. This study was undertaken to assess any possible influence of false-positive scintigraphic results on the prognosis of hypertensive p...

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Bibliographic Details
Published in:International journal of cardiology 2007-04, Vol.117 (2), p.178-183
Main Authors: Michaelides, Andreas P, Tousoulis, Dimitrios, Fourlas, Christos A, Vyssoulis, Gregory P, Andrikopoulos, George K, Aznaouridis, Konstantinos A, Stefanadis, Christodoulos I
Format: Article
Language:English
Subjects:
Adult
Arterial hypertension
Arterial hypertension. Arterial hypotension
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Cardiovascular
Chest Pain - diagnostic imaging
Chest Pain - epidemiology
Coronary Angiography
Coronary artery disease
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - epidemiology
Coronary heart disease
Echocardiography
Exercise Test
False Positive Reactions
Female
Follow-Up Studies
Heart
Humans
Hypertension - diagnostic imaging
Hypertension - epidemiology
Infero-posterior reversible perfusion defect
Male
Medical sciences
Middle Aged
Prognosis
Radionuclide Ventriculography
Risk Factors
Thallium Radioisotopes
Thallium-201 scintigraphy
Tomography, Emission-Computed, Single-Photon - methods
Tomography, Emission-Computed, Single-Photon - standards
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Summary:Abstract Background It has been previously postulated that Thallium-201 (Tl201 ) scintigraphy is characterized by relatively low specificity in hypertensive patients. This study was undertaken to assess any possible influence of false-positive scintigraphic results on the prognosis of hypertensive patients. Methods The study group comprised 179 consecutive hypertensive patients (128 men and 51 women), aged 50 ± 7 years, who underwent exercise Tl201 scintigraphy and coronary angiography (patients with normal scintigraphic results underwent coronary angiography due to persistent angina-like symptoms). All patients with normal coronary arteries underwent a second Tl201 scintigraphy within 36 ± 6 months. Patients with reversible ischemia in the second scintigraphy underwent also a second coronary angiography. Results Coronary artery disease (CAD) was detected in 78 (44%) patients, while the rest 101 (56%) patients had normal coronary arteries. Abnormal scintigraphic results were revealed in 66 (85%) patients with CAD and in 38 (38%) patients without CAD. Twenty-two (58%) of the 38 hypertensive patients with false-positive scintigraphic results presented reversible ischemia of the infero-posterior wall of the left ventricle. Coronary artery disease was detected in 7 (32%) of these patients during the follow-up period. Conclusions Hypertensive patients with normal coronary arteries and false-positive scintigraphic results usually present with reversible ischemia of the infero-posterior wall of the left ventricle. This group of patients seems to be at increased risk of developing CAD in a long-term follow-up period.
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2006.06.011