TECHNETIUM-99M-HMPAO BRAIN SPECT IN PATIENTS WITH SYNDROME-X

Etiology and pathogenesis of syndrome X (angina and positive stress wi th angiographically normal epicardial coronary arteries) are poorly un derstood. There is, however, evidence of a structural or functional al teration of prearteriolar myocardial vessels with a reduced vasodilato r reserve due to endothelial dysfunction.(1-3) Neuroregulatory abnorma lities, extracardiac symptoms like migraine, and pathologic pain perce ption could be demonstrated in patients with syndrome X, pointing to a more generalized disease.(4-6) While most studies focus on functional changes of the heart, Sax et al(7) were also able to demonstrate a re duced vasodilator reserve of the forearm. Following their hypothesis o f a systemic vascular disorder, we performed single-photon emission co mputed tomography (SPECT) of the brain in 95 patients with syndrome X.