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[Hyperemic reactivity scintigraphy in endothelial function].

OBJECTIVE
The aim of this study was to compare a recently described method to evaluate endothelial function; the hyperemic reactivity scintigraphy (HRS) with the ultrasonographic flow-mediated dilatation (FMD) in brachial artery and its relationship with myocardial SPECT.


METHODS
42 consecutive patients that underwent myocardial scintigraphy were included. Thirty-six patients had simultaneous measurement of FMD. Both studies were obtained after 5 minutes occlusion of the upper arm with a blood pressure cuff inflated at 250 mmHg. HRS was performed dynamically at rate 1 frame/sec during 3 minutes after intravenous injection of 740 MBq of Tc-99 sestamibi. Time-activity curves allowed obtaining the following indexes: medium hyperemic activity/medium contrallateral activity (MHA/MCA) and maximum hyperemic activity/maximum contrallateral activity (MxHA/CxHA).


RESULTS
In 13 patients SPECT was normal. Twenty-nine patients had perfusion defects in scintigraphy. There was relationship between the FMD and the MHA/MCA (r = 0.23; p = 0.018) and the FMD and the MxHA/CxHA (r = 0.18; p = 0.05). Patients with alterations in the SPECT had an index MxHA/CxHA lower than patients with normal SPECT (1.8 +/- 0.2 vs 1.5 +/- 0.4; p = 0.04). We did not find relationship between FMD and alterations in SPECT.


CONCLUSIONS
There is relationship between FMD and HRS. HRS is lower in patients with perfusion defects in the SPECT. HRS could provide additional value to myocardial scintigraphy.