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

患有胸痛的女性接受非侵入性测试， 确定他们的疼痛病因发现有很高的发病率， “假阳性”响应，即，结果提示诱导型 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”的重要性， 胸痛和冠状动脉正常女性的无创性检测 血管造影，26名女性< 60岁，胸痛，冠状动脉正常 血管造影和正常静息左心室功能， 放射性核素血管造影评价左心室功能 分级仰卧自行车测力计和运动铊造影术， 标准布鲁斯方案 9名妇女有不正常的运动左 心室功能（左心室射血分数降低或 运动期间检测到室壁运动异常）和17名女性 运动左心室功能正常。 9名妇女中有6名（67%） 运动异常者左心功能存在可逆性缺损 通过铊造影，相比之下，只有1/17（6%）的女性 运动左室功能正常组（P<0.003）。 没有 运动心电图或固定性铊缺陷与 锻炼左心室功能。 因此，异常的左心室 胸痛和正常女性对运动的功能反应 冠状动脉造影通常与异常的证据有关， 心肌灌注，最可能代表冠状动脉异常 微血管的功能。

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.