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


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.

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