ОДНОФОТОННАЯ ЭМИССИОННАЯ КОМПЬЮТЕРНАЯ ТОМОГРАФИЯ В ПРОБАХ С ФИЗИЧЕСКОЙ НАГРУЗКОЙ ПРИ БЕЗБОЛЕВОЙ ИШЕМИИ МИОКАРДА

Abstract

Abstract. Introduction. In the diagnosis of silent myocardial ischemia, single-photon emission computed tomography is of great importance. One of the methods for detecting silent myocardial ischemia is the assessment of its perfusion. For this, single-photon emission computed tomography is considered to be a highly sensitive method. It is the "gold standard" in the diagnosis of transient myocardial ischemia due to both coronary and non-coronary causes. Aim. The aim of the study was to analyze the data of single-photon emission computed tomography at rest and after a stress test in patients with silent myocardial ischemia and the usual form of angina pectoris. Material and methods. 78 case histories of patients with silent and ordinary myocardial ischemia were analyzed. Bicycle ergometry was used as a stress test. The dynamics of perfusion, contractility and electrocardiographic picture were evaluated. Statistical analysis was carried out using parametric and nonparametric criteria. Results and discussion. Patients with silent myocardial ischemia are significantly less likely to undergo coronary stenting and coronary bypass grafting compared to the group with typical angina pectoris. The most common reason for stopping the exercise test in the group with silent myocardial ischemia is ST depression, which occurs 6 times more often than in patients with the usual form of angina. In the group with silent myocardial ischemia, a decrease in myocardial contractility is observed 20% more often, 2.5 times less often there are ventricular extrasystole, 3 times more often there is a hypertonic type of reaction to physical activity than in patients with the usual form of angina pectoris. Conclusion. Single photon emission computed tomography using stress tests reveals differences in patients with silent and ordinary forms of myocardial ischemia.