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European Heart Journal 1993 14(7):891-897;
Copyright © 1993 by the European Society of Cardiology.
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© 1993 The European Society of Cardiology

Coronary angiographic changes during 2 years after myocardial infarction largely undetected by repeated tomographic thallium-201 scintigraphy and not reflected by clinical symptoms

C. G. ERICSSON*,, A. HAMSTEN{dagger}, C. LANDOU{ddagger}, L. MESKO§, R. MüLLER-SURR||, J. NILSON{dagger} and U. DE FAIRE{dagger}

*Departments of Medicine, Danderyd Hospital Stockholm, Sweden
{dagger}Departments of Medicine, Karolinska Hospital Stockholm, Sweden
{ddagger}Department of Thoracic Radiology, Karolinska Hospital Stockholm, Sweden
§Department of Medical Physics, Danderyd Hospital Stockholm, Sweden
||Department of Clinical Physiology, Danderyd Hospital Stockholm, Sweden

Received 6 May 1992; revised 24 February 1993; .

Correspondence:: Dr Carl-Göran Ericsson, Cardiology Division, Department of Medicine, Danderyd Hospital, S-182 88 Danderyd, Sweden

Abstract

Repeated coronary angiographies and single photon emission computed tomographies (SPECT) were performed at 9 and 33 months after myocardial infarction (MI) in 47 young men. Coronary lesions were classified in eight grades with respect to the reduction of the luminal diameter. The progression and regression of two steps or more in lesions of grade 2 or more, the recanalization of coronary thrombosis and an increase in collaterals were recorded. Patients were divided into three groups with regard to (A) deterioration, (B) improvement and (C) no changes in the three major coronary regions, respectively. Overall, 23 patients (49%) showed changes between the first and the second investigation.

A simplified method using summarized short-axis slices for evaluation of the thallium-201 SPECT showed a signficant dfference in change of regional myocardial uptake of thallium-201 between groups A and B (P = 0.047) but not between the groups A and C, in lateral myocardial regions. No signficant dfferences were found between any of the groups in respect of the anterior or inferior myocardial regions. These findings were not explained by changes in clinical status, maximum heart rate or workload, or by changes in medication.

Our results suggest that substantial changes in coronary morphology can take place during the 2 years following MI without consistent changes in clinical symptoms or regional myocardialperfusion.

Key Words: Thallium radioisotope • scintigraphy • tomography • coronary angiography • atherosclerosis • repeated • comparative studies


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