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Colegio de Medicina Interna de México.

2007, Number 3

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Med Int Mex 2007; 23 (3)

Abnormal myocardial perfusion and cardiac X syndrome

Hernandez GT, Castillo ML, Orea TA, Asensio LE, Corzo LD, Narváez DR, Dorantes GJ, Cano GA, Navarro CI, Sánchez GL

Language: Spanish
References: 25
Page: 205-209
PDF size: 124.13 Kb.


ABSTRACT

Background: Cardiac X syndrome is characterized by abnormalities that determine the individual clinical presentation, such as angina chest pain, abnormal electrocardiogram, ischemic ST depression during physical exercise test and normal coronary angiography. Microvascular dysfunction has been proposed as the pathophysiological mechanism, in which endothelial dysfunction, muscle cell abnormality and inflammation are its components. These abnormalities could have been associated to a reverse perfusion phenomenon in cardiac scintigraphy of patients with cardiac X syndrome.
Objective: To determine this association in our population.
Material and methods: Forty-two patients with cardiac X syndrome underwent pharmacological stress test with IV dipyridamole looking for cardiac scintigraphic abnormalities.
Results: Patients without X syndrome had more myocardial perfusion abnormalities, included reverse redistribution phenomenon, when compared to patients with cardiac X syndrome (p = 0.003). Patients who had severe reverse redistribution phenomenon were more hypercholesterolemic and diabetic. They also had worse left ventricular ejection fraction compared with patients who did not show this perfusion abnormality (48.3 ± 15 vs 61.5 ± 15.3, p ‹ 0.05).
Conclusion: SPECT Tc99m-sestamibi failed to show that reverse perfusion phenomenon is more frequent in cardiac X syndrome patients.


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