"FALSE POSITIVE" RADIONUCLIDE ANGIOGRAPHIC STUDIES IN WOMEN WITH CHEST PAIN

患有胸痛的女性，她们接受非侵入性测试，以便 确定他们疼痛的病因被发现有很高的发病率 “假阳性”反应，即提示可诱导的结果 无冠状动脉造影证据的心肌缺血 动脉疾病。为了评估“假阳性”的意义 冠状动脉正常的胸痛患者的无创性检测 冠状动脉造影术，26例女性，60岁，胸痛，冠状动脉正常 血管造影术和正常的静息左心功能 放射性核素血管造影术评价急性心肌梗死患者左心功能 使用分级仰卧位自行车测功术和运动铊闪烁照相 标准的布鲁斯协议。9名女性有不正常的运动 心功能(左心室射血分数降低或 在运动期间检测到室壁运动异常)和17名女性 运动左心功能正常。9名女性中有6名(67%) 运动异常时，左心功能存在可逆性缺陷 通过铊闪烁成像，相比之下，17名女性中只有1名(6%)患有 正常运动左心功能(P&lt；0.003)。根本没有 运动性心电图或固定性铊缺陷症与运动功能的相关性 锻炼左心功能。因此，异常的左心室 胸痛和正常女性对运动的功能反应 冠状动脉造影术通常与异常的证据有关。 心肌灌注，最有可能代表冠状动脉异常 应激状态下的微血管功能。

Women with chest pain who undergo noninvasive testing in order to determine etiology of their pain are found to have a high incidence of "false positive" responses, i.e., results suggestive of inducible myocardial ischemia in the absence of angiographic evidence of coronary artery disease. In order to assess the significance of "false positive" noninvasive testing in women with chest pain and normal coronary angiograms, 26 women < 60 years of age with chest pain, normal coronary angiograms and normal resting left ventricular function underwent radionuclide angiographic assessment of left ventricular function during graded supine bicycle ergometry and exercise thallium scintigraphy using the Standard Bruce Protocol. Nine women had abnormal exercise left ventricular function (left ventricular ejection fraction decreased or wall motion abnormalities were detected during exercise) and 17 women had normal exercise left ventricular function. Six of 9 (67%) women with abnormal exercise left ventricular function had reversible defects by thallium scintigraphy, compared to only 1 of 17 (6%) women with normal exercise left ventricular function (p<0.003). There was no correlation between the exercise EKG or fixed thallium defects and exercise left ventricular function. Thus, abnormal left ventricular functional responses to exercise in women with chest pain and normal coronary angiograms are commonly associated with evidence of abnormal myocardial perfusion, most likely representing abnormal coronary microvascular function during stress.