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  • Title: Alterations in myocardial perfusion during painless ST-segment depression in patients with angina pectoris.
    Author: Ando J, Yasuda H, Koya T, Matsumura N, Kojima S, Miyamoto A, Kanamori K, Kobayashi T.
    Journal: Jpn Heart J; 1985 Mar; 26(2):179-89. PubMed ID: 4009962.
    Abstract:
    In order to determine whether painless ST changes represent myocardial ischemia, we studied regional myocardial perfusion in patients with angina pectoris who showed painless ST-segment depression during a treadmill exercise test. Twenty-one patients were evaluated by myocardial imaging using thallium-201 injected intravenously during exercise when painless ST-segment depression was evident. The same examination was repeated in 5 of the above patients when they showed ST-segment depression with chest pain. Myocardial images obtained during painless ST-segment depression revealed perfusion defects in 15 of 21 patients (71%). Images obtained during ST-segment depression with chest pain showed perfusion defects in all 5 patients (100%) including 3 patients who demonstrated no defects during painless ST-segment depression. In these 5 patients, the ST-segment depression associated with pain was significantly greater than that without pain (3.4 +/- 1.1 vs 2.1 +/- 1.1 mm, p less than 0.01). These results suggest that the majority of episodes of painless ST-segment depression occurring during exercise are accompanied by regional myocardial perfusion abnormalities and that transient painless ST-segment depression in patients with angina pectoris might represent less severe myocardial ischemia.
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