Υποκλινική στεφανιαία νόσος σε ασθενείς με αγγειακό εγκεφαλικό επεισόδιο

Abstract

To assess the myocardial status in patients with stroke, employing myocardial perfusion imaging (MPI) with99mTechnetium-tetrofosmin (99mTc-TF)-single-photon emission computed tomography (SPECT). Methods: Fifty-two patientswith ischemic stroke were subjected to 99mTc-TF-SPECT MPI within 1 month after stroke occurrence. None of the patients hadany history or symptoms of coronary artery disease or other heart disease.Myocardial perfusion imaging was evaluated visuallyusing a 17-segment polar map. Myocardial ischemia (MIS) was defined as present when the summed stress score (SSS) was >4; MISwas defined as mild when SSS was 4 to 8, and moderate/severe with SSS ≥9. Patients with SSS >4 were compared to patients withSSS <4. Parameters such as age, body mass index, waist perimeter, smoking habits, and medical history (diabetes mellitus,dyslipidemia, etc) were evaluated according to MPI results. Results:Myocardial ischemia was present in 32 (62%) of 52 patientswith stroke. Among them, 20 (62%) of 32 patients had mild abnormalities and 12 (38%) of 32 had moderate/severe. The age andwaist perimeter showed a tendency to relate to severe MIS when patients with SSS >9 were compared to patients with SSS <4. InMPI-positive patients, an age was to be association with SSS, with the oldest age exhibiting the highest SSS (P Ό .01). Theassociation of age with SSS remained statistically significant in the multivariate analysis (P Ό .04). Conclusion: The study suggestedthat more than half of patients with stroke without a history of cardiac disease have MIS. Although most of them have mildMIS, we suggest a thorough cardiological evaluation in this group of patients for future prevention of severe myocardial outcome.

Μελετήθηκε η κατάσταση του μυοκαρδίου σε ασθενείς με πρόσφατο αγγειακό εγκεφαλικό επεισόδιο χωρίς ιστορικό καρδιακής νόσου. Ο έλεγχος διενεργήθηκε με σπινθηρογράφημα αιμάτωσης του μυοκαρδίου με τετραφωσμίνη (99mTc-TFSPECT).Στη μελέτη συμπεριελήφθησαν 52 ασθενείς με μέση ηλικία 55,6 έτη. Από τους 52 ασθενείς, οι 32 είχαν MIS, με SSS ≥4 (62%), ενώ 20 ασθενείς είχαν SSS <4 ( 38%).Όλα τα μη φυσιολογικά 99mTc-TFSPECT ήταν χωρίς κλινικά ευρήματα.Οπότε προέκυψε μη φυσιολογική αιμάτωση του μυοκαρδίου σε ποσοστό 62% σε ασθενείς με πρόσφατο εγκεφαλικό επεισόδιο.