Myocardial perfusion scintigraphy and percutaneous coronary intervention in patients with stenotic coronary artery disease

Purpose of research. To study the relationship of varying degrees of stenotic lesions of the coronary arteries (CA) with the results of myocardial perfusion scintigraphy in railway workers before and after percutaneous coronary intervention (PCI). Material and methods. The study included 130 patients with SC stenosis more than 50% of the lumen (according to the results of invasive coronary angiography), all underwent single - photon emission computed tomography (SPECT) of the myocardium according to the two - day Protocol "stress + rest”. When comparing the obtained data, the patients were divided into groups according to the degree of SC stenosis. Results. In 83 patients (group 1), SC stenosis was detected from 50 to 85%, in 47 patients (group 2) SC were stenosed by 85% or more. In ofect persistent defect of myocardial perfusion occurred in 32% of cases, reversible defect of perfusion (deterioration of perfusion in the sample with the load) - in 51%, deterioration of myocardial perfusion at rest (compared with the load) - in 17% of cases. In 56% of patients of the 1st group the deterioration of myocardial perfusion was revealed in the load test. In 60% of patients of group 2 myocardial perfusion disorders were persistent or worse than in the load test. Silent myocardial ischemia was diagnosed in 74% of patients of group 1 and 98% of patients of group 2. Every third patient with SMI conducted percutaneous coronary intervention (PCI), of whom half after PCI held SPECT of the myocardium. There were no cases of worsening myocardial perfusion in group 2 after PCI. In group 1, 6 cases out of 9 showed deterioration of myocardial perfusion or no effect of PCI. Conclusion. Stenotic lesions of KA less than 85% was associated with a higher incidence of deterioration of myocardial perfusion in the test with a load, whereas the CA stenosis more than 85% more likely to worsen the myocardial perfusion alone. All cases of worsening myocardial perfusion after PCI were observed in patients with SC stenosis less than 85%.

однофотонная эмиссионная компьютерная томография, перфузия, ишемическая болезнь сердца, коронарография, чрескожное коронарное вмешательство, single-photon emission computed tomography, perfusion, coronary heart disease, coronary angiography, percutaneous coronary intervention

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