Open Access
American Research Journal of Cardiovascular Diseases
ISSN (Online): 2575-7601
DOI: 10.46568/arjcd
Post-Infarction Myocardial Viability and Angina at Everyday Life Activities versus Treadmill Exercise Test
*aResearch Associate – 1st Department of Cardiology – Onassis Cardiac Surgery Center (Andreas Syggros
Avenue 356, Kallithea 17674, Attiki, Greece.
bDirector – Laboratory of Nuclear Medicine – Onassis Cardiac Surgery Center, Kallithea Attiki, Greece.
cNuclear Medicine Physician – Laboratory of Nuclear Medicine – Onassis Cardiac Surgery Center, Kallithea
Attiki, Greece.
dCardiologist – Director of the Cardiopulmonary Exercise Testing laboratory – 1st Department of Cardiology –
Onassis Cardiac Surgery Center, Kallithea Attiki, Greece.
1Professor of Medicine and Miscia Chair of Interventional Cardiology, University of Nebraska, eEx Associate
Director – Onassis Cardiac Surgery Center, Kallithea Attiki, Greece.
fProfessor – Dean – School of Health Science and Education – Harokopio University, Athens Greece.
gResearcher – Biomedical Research Foundation Academy of Athens, Greece [Ex Director 1st Department of
Cardiology – Onassis Cardiac Surgery Center], Emeritus Professor, University of Athens.
Andreas Karydas, Maria Koutelou, Athanasios Theodorakos, et al., “Post-Infarction Myocardial
Viability and Angina at Everyday Life Activities versus Treadmill Exercise Test”. American Research Journal of
Cardiovascular Diseases, 3(1); pp: 1-12
Abstract
Background: Myocardial viability (VIA) prevalence in post myocardial infarction (MI) patients (pts) in
association with angina (ANG) or not has not been prospectively evaluated.
Methods and Findings: Fifty-five post-MI pts with reduced ejection fraction (EF≤40%) underwent stress
thallium-201 scintigraphy (Tl-201) viability (VIA) evaluation. ANG at exercise-treadmill-test (ETT) (Borg
scale) and at everyday-life (Canadian Cardiovascular Society – CCS) classification was recorded. Groups VIA
(29 pts – 53%) vs non-VIA respectively had similar EF (31 ± 7)% vs (33 ± 8)% (NS), higher diseased vessels
number 2.8 ± 1.6 vs 1.9 ± 1.3 (p=0.02), CCS 1.7 ± 0.8 vs 1.3 ± 0.6 (p<0.05), CCS≥2 71% vs 41% (p<0.03). Five
pts from each group reported ETT ANG (17% vs 21% – NS), with Borg scale 7.7 ± 3.0 vs 7.2 ± 2.4 (NS). CCS≥2
was associated with greater 201Tl reversibility indices within stress defect (p<0.04) or total myocardial mass
reversibility (p<0.02). Binary logistics analysis associated VIA positively with number of diseased vessels and
negatively with smoking, while CCS≥2 ANG positively with number of diseased vessels. The main limitation is
the relatively small number of pts.
Conclusions: Viability, while not significantly correlated to ETT angina, was positively associated only with
more frequent everyday-life (CCS) angina. Clinically, in ischemic cardiomyopathy VIA evaluation is indicated,
regardless of ANG.
