ORIGINAL ARTICLES   

International Angiology 2003 December;22(4):401-6

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English

Asymptomatic myocardial ischemia in relation to carotid artery stenosis among patients with aortic aneurysm

Iwamoto T. ¹, Oyama T. ¹, Shizuka K. ¹, Takasaki M. ¹, Chikamori T. ², Ishimaru S. ³

¹ Brain and Blood Vessel Laboratory, Department of Geriatric Medicine, Tokyo Medical University Hospital, Tokyo, Japan 2 Cardiovascular Division, Department of Internal Medicine, Tokyo Medical University Hospital, Tokyo, Japan 3 Department of Cardiovascular Surgery, Tokyo Medical University Hospital, Tokyo, Japan

Aim. The prev­a­lence of asymp­to­mat­ic cor­o­nary ­artery sten­o­sis in rela­tion to carot­id ­artery sten­o­sis is influ­enced by the under­ly­ing dis­ease and has yet to be clar­i­fied.
Meth­ods. A total of 124 con­sec­u­tive Jap­a­nese ­patients with aor­tic aneu­rysm, but with­out symp­toms of cor­o­nary ­artery sten­o­sis, were divid­ed into 2 ­groups on the basis of carot­id ultra­so­nog­ra­phy: the carot­id sten­o­sis group (≥50% lumi­nal diam­e­ter nar­row­ing) and the non-sten­o­sis group. Myo­car­dial imag­ing was per­formed using thal­i­um-201 chlo­ride and aden­o­sine tri­phos­phate dis­odi­um.
­Results. The mean age and inci­dence of both cereb­ro­vas­cu­lar dis­ease and periph­er­al ­artery dis­ease were sig­nif­i­cant­ly high­er in the sten­o­sis group (n=24) than the non-sten­o­sis group (n=100). Defin­ing both fixed and rever­sible hypo­per­fu­sion as pos­i­tive on the basis of myo­car­dial imag­ing, a sig­nif­i­cant­ly high­er num­ber of pos­i­tive find­ings were found in the sten­o­sis group (15/24; 62.5%) than in the non-sten­o­sis group (32/100, 32.0%), (Odds ratio: 3.54; p<0.01). The dis­tri­bu­tions of hypo­per­fu­sion ­defects in the sten­o­sis group were sim­i­lar to those in the non-sten­o­sis group, but fixed hypo­per­fu­sion was more fre­quent­ly seen in the sten­o­sis group.
Con­clu­sion. The high prev­a­lence of pos­i­tive find­ings in the sten­o­sis group indi­cates that carot­id ­artery sten­o­sis is fre­quent­ly asso­ciat­ed with cor­o­nary ­artery sten­o­sis even in asymp­to­mat­ic ­patients, and could be an indi­ca­tor for ­advanced ath­ero­scler­o­sis of the cor­o­nary ­artery. The ­results con­firm that ­stress myo­car­dial imag­ing is inval­u­able in the detec­tion of cor­o­nary ­artery sten­o­sis, par­tic­u­lar­ly in ­patients with carot­id arte­rio­scle­ro­sis.