Authors:
A. Johansen, P.F. Hoilund-Carlsen¹, H.W. Christensen², W. Vach³, M. Moldrup¹, T. Haghfelt⁴, Odense University Hospital - Odense C - Denmark, ¹Odense University Hospital - Odense - Denmark, ²Nordic Institute - Odense - Denmark, ³University of Southern Denmark - Odense - Denmark, ⁴Odense University Hospital - Odense C - Denmark,

Aim: We wanted to examine the relationship between symptoms and perfusion before and after revascularization in patients with stable angina.

Methods: 380 patients (147 females), aged 58.0 ± 8.8 years, referred to coronary angiography due to known or suspected stable angina were classified as suffering from typical/atypical angina or non-cardiac chest pain/no pain. Myocardial perfusion imaging (MPI) using a dual isotope (exercise/pharmacological 169/211) protocol was performed. The choice of management (revascularization or medicine only) was based on history and angiographic findings since the MPI results were not communicated. Follow-up, including repeat MPI, was completed after 2-years.

Results: 144 (38%) patients were revascularized. Initially, 320 (84%) had typical/atypical angina and 60 (16%) non-cardiac chest pain/no pain. At follow-up, 145 (38%) had typical/atypical angina, while 235 (62%) had non-cardiac chest pain/no pain. However, when separated according to treatment, a significant difference could be demonstrated in revascularized patients only. Sum stress score (SSS) was significantly reduced in revascularized patients, and not significantly changed in non-revascularized patients. The relationship between type of chest pain and perfusion status in revascularized patients is shown in Figure 1. Among patients with initially typical or atypical angina (designated typ), it was only those who had non-cardial chest pain or no pain at follow-up (designated ncp) who had a significant reduction in SSS. In non-revascularized patients, there were no significant changes.

Conclusion: A relationship between perfusion and angina type was documented in that relief of typical or atypical angina was associated with improvement of perfusion.