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Rheumatology Advance Access published online on April 10, 2008
Rheumatology, doi:10.1093/rheumatology/ken084
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Myocardial ischaemia in patients with primary APS: a 13N-ammonia PET assessment

E. Alexánderson1,2, A. Gómez-León1, A. Vargas1, J. L. Romero2, C. Sierra Fernández2, M. Rodriguez Valero2, L. García-Rojas2, A. Meave1 and M.-C. Amigo1

1Instituto Nacional de Cardiología Ignacio Chávez and 2PET-Ciclotrón Unit, UNAM (PET-UNAM), Mexico City, México.

Correspondence to: E. Alexánderson, Juan Badiano No. 1. Colonia Sección XVI CP 14080, México D.F. E-mail: alexanderick{at}yahoo.com


  Abstract

Objective. Evaluate the presence and severity of myocardial ischaemia in a population of asymptomatic patients with primary APS (PAPS) using 13N-ammonia PET.

Methods. We studied 36 patients, 18 with a diagnosis of PAPS and 18 healthy volunteers. All patients underwent a two-phase (rest–stress) 13N-ammonia PET. Myocardial perfusion images were acquired and then analysed by two experts in the field.

Results. We found ischaemia in 7/18 asymptomatic PAPS patients (38.8%). The anterolateral wall was the most commonly affected cardiac territory [5/7 PAPS patients (71.4%)]. In a severity analysis, we found that five patients (71.4%) had mild ischaemia, one patient (14.2%) had moderate ischaemia and another one (14.2%) had severe defects. All the healthy volunteers studied showed normal myocardial perfusion images.

Conclusion. An important proportion of PAPS patients, even when asymptomatic, showed myocardial perfusion defects assessed with PET. Most of the ischaemic patients had mild defects and the anterolateral wall was the territory mainly affected.

KEY WORDS: Primary anti-phospholipid syndrome, Ischaemia, Positron emission tomography, 13N-ammonia, Thrombosis, Coronary disease, Ischaemic heart disease, Autoimmune diseases, Heart, Cardiovascular imaging

Submitted 20 July 2007; revised version accepted 4 February 2008.
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