Inferior myocardial wall ischemia on SPECT-MPI in patients with non dominant right coronary artery and non significant coronary artery disease

Int J Cardiol. 2022 Jul 1:358:8-10. doi: 10.1016/j.ijcard.2022.04.058. Epub 2022 Apr 23.

Abstract

Background: The impact of a non-dominant right coronary artery (NDRCA), on single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI)has not been clarified.

Methods and results: We compared SPECT-MPI results of consecutive patients without significant (diameter stenosis ≥50%)coronary artery disease (CAD) and a NDRCA (Group-1), with those of patients from our database without CAD and a dominant RCA (Group-2). All patients were subjected to SPECT-MPI with I.V. infusion of adenosine, and TC99-tetrofosmin. Group-1 included 69 patients (55 men, 79.7%), mean age 66.8 ± 9.8 years. Group-2 consisted of 79 patients (56 men, 70.9%), mean age 62.7 ± 11.5. There was no difference in demographics and CAD risk factors between the two groups. The SPECT-MPI revealed inferior wall ischemia, in 35 patients (50.7%), in Group-1 and 27 patients (34.1%), in Group-2 (P = 0.041).

Conclusions: A relatively high rate of reversible SPECT-MPI perfusion defects may be anticipated in patients with an unobstructed NDRCA compared to patients with a dominant RCA.

Keywords: Inferior wall ischemia; Non dominant RCA; SPECT.

MeSH terms

  • Aged
  • Coronary Angiography / methods
  • Coronary Artery Disease* / diagnostic imaging
  • Humans
  • Male
  • Middle Aged
  • Myocardial Ischemia* / diagnostic imaging
  • Myocardial Perfusion Imaging* / methods
  • Tomography, Emission-Computed, Single-Photon / methods