Comparison of exercise stress test, myocardial perfusion scintigraphy and coronary flow features in patients with normal coronary angiogram

In this retrospective study , coronary flow features of the 165 subject having normal coronary artery was investigated. All of the subjects have EST (exercise stress test) and MPS (myocardial perfusion scintigraphy) and the diagnostic predictive values such as sensitivity , spesificity , (+) and (-) predictive values and diagnostic values was also researched. The correlation between the EST, MPS TFC (TIMI frame count) results and major coronary risk factors were evaluated.Patients with LVEF<40%, severe valvular disease, hemodynamically significant arrythimias, uncontrolled hypertension, malignancies, history of previous revascularization, cardiomyopathies, acute coronary syndromes, severe renal dysfuntion, liver an d tyhroid disordes, pregnancy, and LV hypertrophy were excluded.CSX (cardiac syndrome X) and coronary slow flow was detected as 27,9% , 29,1% in study subjects , respectively. In 10% of the subject CSX and coronary slow flow were both found to be together.Diagnostic value of EST and MPS were similar in the whole study and slow coronary flow patient groups. There were more risk factors and ischemic ECG changes in patients with slow coronary flow.In summary, as potential causes for microvascular angina the CSX and slow coronary flow should not be left without treatment. These patients have still greater cardiovascular risk than the patients without microvascular dysfunction.