老年下肢动脉硬化症肱动脉及股浅动脉舒张功能的对比研究

目的　了解老年下肢动脉硬化症(LEASD)患者肱动脉及股浅动脉内皮依赖性舒张功能 (血流介导的血管扩张功能 ,FMD)和硝酸甘油介导的非内皮依赖性舒张功能 (NMD) ,并评价二者的相关性及特点。方法　采用高分辨率超声诊断系统检测 33例老年LEASD患者 (Ⅰ组 )肱动脉及股浅动脉的FMD及NMD ,并分别与 4 0例健康老人 (Ⅱ组 )及 30例具有心血管危险因素的老年非LEASD患者(Ⅲ组 )进行对照研究。结果　老年LEASD患者肱动脉的FMD(3 5 6 %±1 92 % )及NMD(8 5 4 %± 4 72 % )与股浅动脉的FMD(2 16 %±1 2 2 % )和NMD(5 2 7%± 3 6 9% )均显著低于Ⅱ组和Ⅲ组 (P <0 0 5 )。老年LEASD患者股浅动脉的FMD显著低于肱动脉的FMD(P =0 0 0 0 8) ;股浅动脉的NMD亦显著低于肱动脉的NMD(P =0 0 0 2 6 ) ;而股浅动脉的FMD与肱动脉的FMD相关性好 (r=0 9314 ,P <0 0 1) ,两者的NMD亦有较好的相关性(r=0 9191,P<0 0 1)。结论　老年LEASD患者肱动脉及股浅动脉的FMD及NMD均受损 ;对于老年LEASD患者FMD及NMD的检测 ,股浅动脉与肱动脉相关性好 ,股浅动脉的FMD及NMD能更敏感、更直接地反映老年LEASD患者的血管反应性     

超声检测非酒精性脂肪肝病患者肱动脉内皮功能

目的:评价非酒精性脂肪性肝病患者的肱动脉内皮功能。方法:选取50例非酒精性脂肪性肝病患者和40例健康对照者,应用高频超声测量静息状态下、反应性充血后、舌下含服硝酸甘油后的肱动脉内径,并计算反应性充血和硝酸甘油诱发的内径百分变化率。检测血胰岛素抵抗(IR-HOMA)并进行统计学分析。结果:非酒精性脂肪性肝病组反应性充血诱发的肱动脉内径百分变化率显著低于对照组(P<0.001),而两组对硝酸甘油的反应差异无显著性意义(P>0.05);内皮依赖性舒张功能(D1%)与IR-HOMA呈负相关(r=-0.243,P=0.030)。结论:非酒精性脂肪性肝病患者早期即存在血管内皮依赖性舒张功能障碍。     

超声检查血管内皮功能及颈动脉和股动脉内中膜厚度临床价值分析

目的 探讨超声联合血管内皮功能及颈动脉和股动脉内中膜厚度检查对冠心病的诊断价值.方法 采用高频超声技术研究冠心病患者的肱动脉内径（D0）、血流介导的血管舒张反应（FMD）,硝酸甘油介导的血管舒张反应（NMD）等肱动脉血管内皮舒张功能,以及颈动脉、股动脉（intima media thickness,IMT）,探讨肱动脉、颈动脉以及股动脉作为反映冠状动脉粥样硬化体表窗口的可行性.结果 对冠心病组和非冠心病的对照组的肱动脉血管内皮舒张功能进行比较发现冠心病组的D0明显大于对照组;而冠心病组的FMD和NMD则明显低于对照组,且差异具有统计学意义（t=2.95、5.36、4.95,P＜0.05）.对冠心病组患者中单支病变和多支病变患者的肱动脉血管内皮舒张功能进行比较发现多支病变组的FMD和NMD则明显低于单支病变组,且差异具有统计学意义（t=3.11、4.36,P＜0.05）.在冠心病组中单支病变组的颈动脉IMT和股动脉IMT均明显低于多支病变组,而这两组的颈动脉IMT和股动脉IMT均明显高于对照组,且差异具有统计学意义（F =2.65、2.85,P＜0.05）.结论 超声检测可早期发现冠状动脉粥样硬化,为治疗和预防冠状动脉疾病提供依据.     

餐后血脂抑制甲状腺功能减退症患者的内皮依赖性血管舒张功能

目的探讨临床甲状腺功能减退症(简称甲减)和亚临床甲减患者餐后血脂与血管内皮功能的关系。方法选择10名正常女性受试者为对照组,20名甲减患者分成两组:临床甲减组与亚临床甲减组(每组各10例)。采用高分辨血管外超声法检测肱动脉血流介导的内皮依赖性血管舒张功能和硝酸甘油(GNT)介导的内皮非依赖性血管舒张功能。结果餐后血脂引起甲减患者血管内皮功能异常与三酰甘油和自由基水平密切相关。脂肪餐负荷试验中,甲减患者及正常对照组在餐后4 h时,内皮依赖性血管舒张功能降低(P<0.05),对照组和亚临床甲减组患者在8 h时内皮依赖性血管舒张功能恢复到基线水平,亚临床甲减组患者在6 h时内皮依赖性血管舒张功能低于基线水平(P<0.05)。然而,临床甲减组患者在进食脂负荷餐后6 h时内皮依赖性血管舒张功能继续下降(P<0.01),在8 h时开始升高,但仍低于基线水平(P<0.05)。Spearman’s分析显示甲减组(P<0.01)和对照组患者(P<0.05)进食脂负荷餐后内皮依赖性血管舒张功能与三酰甘油﹑硫代巴比土酸反应物质(TBARS)水平呈负相关,而三酰甘油水平与TBARS水平呈正相关。结论进食脂负荷餐后,甲减患者和正常对照组的内皮依赖性血管舒张功能降低,且与血清三酰甘油和氧自由基水平密切相关。     

少数民族地区健康人群血管内皮功能的影响因素及超声诊断价值

目的 :探讨广西少数民族地区健康人群血管内皮功能的影响因素及超声诊断价值。方法 :选取广西少数民族地区749例20~80岁健康人群作为研究对象,内容涉及问卷、一般体格检查及超声检测肱动脉血流介导内皮依赖性舒张功能(FMD)、反应性充血前后的肱动脉血管内径、血流速度及出现变化的时间。结果:不同民族、年龄、性别、吸烟组的FMD差异有统计学意义;Logistic回归分析结果显示,民族、年龄、性别是FMD的独立影响因素;相关性分析显示,FMD与肱动脉血管内径、管腔内血流速度呈显著负相关,与扩张达峰时间及最大血流速度出现时间呈显著正相关。结论:FMD存在民族差异性,年龄、性别与血管内皮功能损害的发生有关,超声检测指标可评估血管内皮功能的变化。     

轻度非酒精性脂肪肝血管内皮功能改变与颈动脉内中膜厚度的相关性

目的探讨轻度非酒精性脂肪肝(NAFLD)患者血管内皮功能的改变及其与动脉粥样硬化的关系。方法选择健康体检的130例轻度NAFLD患者(NAFLD组)及120例健康者(对照组)进行肱动脉内皮舒张功能和颈动脉超声检测。结果 NAFLD组肱动脉内皮依赖性舒张功能(FMD)及非内皮依赖性舒张功能(NMD)分别为(11.92±3.28)%及(17.64±2.28)%,显著低于对照组[分别为(15.34±3.00)%及(22.38±2.34)%,P均0.001)。NAFLD组颈动脉内膜中层厚度(IMT)及斑块发生率显著高于对照组[分别为(0.88±0.18)mm vs.(0.97±0.17)mm,P0.001和36.9%vs. 20.0%,P=0.003)。相关及回归分析显示,FMD及NMD与颈动脉IMT及斑块发生率呈显著负相关,在校正年龄、性别、血压、血脂及血糖等相关混杂因素后,FMD及NMD仍是颈动脉IMT及斑块发生率的独立影响因素。结论轻度NAFLD组患者存在血管内皮功能损伤和颈动脉IMT增厚,NAFLD可能通过引起血管内皮功能紊乱导致动脉粥样硬化的发生。     

肥胖对血管内皮依赖性舒张功能的影响

目的 :用高分辨率超声评价单纯肥胖对血管内皮依赖性舒张功能的影响。方法 :用高分辨率超声检测 4 0例肥胖患者和 38例正常对照组肱动脉反应性充血和含服硝酸甘油后内径的变化。结果 :肥胖组肱动脉血流介导性血管扩张明显减弱 (10 .14± 6 .2 3) %对 (18.96± 6 .92 ) % ,P <0 .0 0 1,而两组对硝酸甘油的反应无显著性差异 (17.96± 6 .91) %对(19.0 1± 5 .81) % ,P >0 .0 5 ;肥胖组肱动脉血流介导性血管扩张与体重指数成负相关关系 (r=- 0 .6 1,P <0 .0 1)。结论 :肥胖患者存在血管内皮依赖性舒张功能障碍。     

冠心病患者血管内皮功能与颈总动脉内中膜厚度的相关性研究

 目的研究冠心病患者颈动脉内-中膜厚度、血管弹性与肱动脉血管内皮功能.方法将研究对象分为3组,Ⅰ组为30名健康人,Ⅱ组为心绞痛型冠心病患者30例,Ⅲ组为冠心病心肌梗死患者30例,用高频超声测量颈动脉内-中膜厚度、收缩期颈动脉内径(DS)、舒张期颈动脉内径(DC),计算颈总动脉壁弹性的相关参数:可扩张度(DC)、顺应性(CC);观察受检者的肱动脉充血反应性扩张(DTRH)和含服硝酸甘油后血管内径的变化(DTNG),并进行对比分析.结果冠心病心肌梗死患者颈动脉内-中膜厚度较心绞痛型冠心病患者、正常对照组增厚(P＜0.01),血管弹性与血管内皮功能明显减低(P＜0.01),心绞痛型冠心病患者较正常对照组血管内皮功能明显减低(P＜0.01),血管内皮功能与颈动脉内-中膜厚度之间有较大相关性,呈负相关,与颈总动脉壁可扩张度、顺应性有较大相关性,呈正相关.结论冠心病患者肱动脉依赖性血管内皮细胞功能减退早于颈动脉内-中膜厚度变化,可与颈总动脉内中膜厚度、血管弹性一起作为监测冠心病病情发展变化及判断预后的客观指标.     

高密度脂蛋白对冠心病患者血管内皮依赖性舒张功能的影响

目的探讨冠心病患者血清中高密度脂蛋白-胆固醇（HDL-C）水平与冠心病患者肱动脉内皮依赖性舒张功能之间关系相关性。方法随机选择血清总胆固醇水平（TC）相对正常的冠心病患者200例为观察组,无血脂改变的正常人200例为对照组。将两组样本血清TC进行实验室测定;并应用B超对肱动脉进行检测扫描记录,在静息、肱动脉充血反应性扩张（DTRH）、含服硝酸甘油后血管内径的变化（DTNG）记录研究对象基线肱动脉二维图象及其多普勒血流图象。计算不同状态下的管径变化及血流介导的内皮依赖性血管扩张率（Flow-MD%）。结果 A组TG、LDL高于B组,HDL低于B组,两组比较,差异均有统计学意义（P〈0.05）;肱动脉扩张度、顺应性、肱动脉充血反应性扩张度A组较B组降低,A组在反应性充血引起血管内径的变化与B组相比明显减弱（P〈0.01）;两组对含服硝酸甘油后血管内径的变化无差异。结论 HDL-C水平的检测及血管内皮细胞功能检查可以作为监测和评估病情变化的指标。     

急性冠脉综合征患者血管内皮功能与冠状动脉病变程度的关系

目的探讨急性冠脉综合征(ACS)病人血管内皮功能与冠状动脉病变严重程度的关系。方法选取经冠状动脉造影确诊的ACS病人43例,以冠脉病变支数和Gensini评分来评价冠脉病变严重程度,同时以我院门诊非冠心病患者30例作为对照组。采用流量介导的肱动脉扩张(FMD)测定来评估血管内皮功能。结果 ACS组FMD水平明显低于对照组(P<0.05),ACS组FMD水平与Gensini评分呈负相关。结论 ACS患者FMD水平明显降低,且FMD水平与冠状动脉病变严重性呈负相关,可作为ACS患者冠状动脉病变严重程度的预测指标。     

Relationship between brachial artery flow-mediated dilation and coronary flow reserve in patients with peripheral artery disease.

The aim of this study was to assess the relationship between brachial artery flow-mediated dilation (FMD) and coronary flow reserve (CFR) in patients with peripheral artery disease (PAD). METHODS: Thirty patients who had PAD, who showed no cardiac symptoms, and who had normal stress SPECT cardiac imaging results and 28 control subjects underwent brachial artery FMD assessment by ultrasound and dipyridamole 99mTc-sestamibi imaging. Myocardial blood flow (MBF) was estimated by measuring first-transit counts in the pulmonary artery and myocardial counts from SPECT images. Estimated CFR was expressed as the ratio of MBF at stress to MBF at rest. RESULTS: Patients with PAD were separated into 2 groups according to the median value of overall FMD (6.85%): group 1 (n=15) with FMD above the median (mean+/-SD, 8.78%+/-1.3%) and group 2 (n=15) with FMD below the median (mean+/-SD, 5.14%+/-0.94%). FMD was significantly higher in control subjects (11.4%+/-3.4%) than in both groups of PAD patients (P<0.001 for both). In control subjects, estimated CFR was 2.2+/-0.4-significantly higher than CFR in both groups of PAD patients (P<0.001 for both). In addition, in PAD patients of group 1, estimated CFR was 1.5+/-0.4-higher than CFR in group 2 (1.0+/-0.4) (P<0.01). When all PAD patients were considered, a significant correlation between FMD and estimated CFR was observed (r=0.56, P<0.005). CONCLUSION: Estimated CFR is significantly lower in patients with PAD than in control subjects, and CFR impairment correlates with the degree of peripheral endothelial dysfunction.     

Coronary artery calcium score assessed by a 64 multislice computed tomography and early indexes of functional and structural vascular remodeling in cardiac syndrome X patients

Background. Regardless of normal coronary angiograms, coronary artery calcium (CAC) can be found in cardiac syndrome X (CSX) patients. According to some data, a relationship between the CAC score and markers of early atherosclerosis in CSX has been observed. Our aim was to assess whether the extent of the CAC score assessed by multislice computed tomography (MSCT) with a 64-slice system in CSX patients is related to brachial artery reactivity, intima-media thickness (IMT), and arterial compliance indexes. Methods and Results. High-resolution ultrasound was used to measure flow-mediated dilatation (FMD) and nitroglycerin-mediated vasodilatation, as well as the following parameters of arterial structural changes: IMT, pulse wave velocity, total arterial compliance, and stiffness index. MSCT was used to assess the presence and the quantity of CAC. The study group consisted of 46 CSX patients (mean age, 56.3±9 years), whereas the control group comprised 21 healthy subjects (mean age, 54.9±7 years). The assessment of the vascular parameters showed significantly decreased FMD and increased IMT in the CSX subjects (9.06%±3.2% and 0.67±0.1 mm, respectively) in comparison to the control subjects (17.42%±8.4% [P=.008] and 0.57 ± 0.2 mm [P=.021], respectively). CAC was detectable in 19 CSX patients (41%) (CAC range according to Agatston score, 2–500; mean, 101.6; median, 26.5) and in 1 control subject (4.8%) (CAC value, 13). CSX patients with detectable CAC were characterized by a significantly higher age (P=.001), lower body mass index (P=.017), and increased stiffness index (P=.020); there were no differences in FMD and IMT values. In a multivariate logistic and linear regression analysis, age was the only risk factor independently associated with the presence of CAC (P=.001) and the log(CAC+1) value (P=.01). In the subgroup of women, log(CAC+1) significantly correlated with age (r=0.587, P=.002) and stiffness index (r=0.427, P=.024), and in a borderline significant manner, it correlated with weight (r=−0.329, P=.07) and waist-hip ratio (r=0.315, P=.07). There were no significant correlations in the male subgroup. Conclusions. Low ranges of CAC are frequently detectable in CSX patients, and the results are age-related and independent of impaired early indexes of functional and structural vascular remodeling.     

妊娠期高血压和子痫前期对孕妇产后血管内皮功能的影响

目的探讨妊娠期高血压(GH)和子痫前期(PE)对孕妇产后血管内皮功能的影响。资料与方法纳入产检并分娩的123例产妇,依据《妊娠期高血压疾病诊治指南》分为正常妊娠的对照组、GH组和PE组。所有研究对象分别于孕前及产后6周、12周和24周进行右侧肱动脉内皮依赖性血流介导的血管扩张(FMD)检测。比较各组不同时间点FMD值和组间相同时间点FMD值;分析产后24周FMD值对GH和PE孕妇产后内皮功能异常的预测价值。结果对照组、GH组和PE组产妇产后不同时期FMD值呈上升趋势(P<0.05)。各组产妇不同时间点FMD值差异有统计学意义(P<0.001)。产后6周、12周及24周组间FMD值为对照组>GH组>PE组,差异均有统计学意义(P<0.05)。年龄、体重指数、舒张压为GH组和PE组FMD值变化的影响因素(P<0.05)。产后24周FMD值对GH及PE产妇产后内皮功能异常具有一定的诊断价值(DRAGON评分AUC=0.821,95%CI 0.756~0.952,P<0.001)。结论GH和PE母体产后的血管内皮功能持续受损。产后血管内皮功能异常对于识别心脑血管疾病高危人群具有重要意义。     

Aging, exercise, and limb vascular heterogeneity in humans

Unlike quadrupeds, human limbs are exposed to differing homeostatic challenges and uses, which results in significant functional heterogeneity between the arms and legs. In these ACSM symposium proceedings, we report findings from three studies with the overall aim of investigating between-limb vascular differences through evaluation of arm (brachial artery) and leg (common, superficial, and deep femoral arteries) limb blood flow (ultrasound Doppler) during isolated-limb-specific exercise and after postcuff occlusion hyperemia. In a study of young, trained cyclists, a substantial conduit vessel vasodilation (deep femoral artery, approximately 9%) was observed during exercise, but responsiveness normalized to shear stimuli was still less than a conduit vessel in the arm. A subsequent aging study did not demonstrate any significant difference in resting leg or arm blood flow between young and old subjects when flow was normalized for muscle mass. However, we observed an approximately 10-15% reduction in exercising leg blood flow and vascular conductance in these older subjects, whereas exercising arm blood flow was similar between age groups. A separate aging study evaluated age-related changes in flow-mediated vasodilation (FMD), with the older group enrolled in a 6-wk knee-extensor exercise training program. Before training, a significant FMD was observed in the arm of young (3 +/- 1%) but not old (1 +/- 1%) subjects, and a significant leg FMD was observed in both groups. However, pretraining arm vasodilation was similar between young and old when normalized for shear rate. Exercise training significantly improved arm FMD (5 +/- 1%), whereas leg FMD was unchanged. Collectively, these studies demonstrate a significant between-limb vascular heterogeneity in humans that is influenced by age and by exercise training.     

Flow-mediated vasodilation predicts the presence and extent of coronary artery disease assessed by stress thallium imaging

BACKGROUND: Endothelial function can be measured by flow-mediated vasodilation (FMD) of the brachial artery and has been associated with cardiac risk factors (RF) and angiographically defined coronary artery disease (CAD). Stress single photon emission computed tomography (SPECT) imaging is commonly used to study patients with CAD. We sought to study the relationship between endothelial dysfunction by FMD and stress thallium SPECT to detect CAD. METHODS AND RESULTS: Fifty-five consecutive patients with chest pain syndrome referred for stress SPECT and eleven healthy control subjects had FMD measured on the brachial artery by standard techniques. The main outcome was the percent of brachial artery diameter dilation from baseline and the number of perfusion defects by SPECT. In subjects with no RF, those with RF but no defects, and those with defects, the mean FMD was 18.88% +/- 2.31%, 7.85% +/- 1.66%, and 5.91% +/- 1.07%, respectively (P < .05). A significant correlation was found between the number of thallium defects and degree of FMD impairment (r = -0.40, P < .01). An FMD cutoff value of less than 7.5% had a 72.5% sensitivity and 73.1% specificity in predicting the presence of any thallium defects. After RF adjustment, FMD remained as the strongest predictor of scintigraphic CAD (odds ratio, 10.96; 95% confidence interval, 2.82-57.31). CONCLUSION: FMD independently predicts the presence and extent of scintigraphic CAD.     

Vascular endothelial dysfunction is associated with reversible myocardial perfusion defects in the absence of obstructive coronary artery disease

Background  The purpose of this study was to investigate whether endothelial dysfunction contributes to abnormal myocardial perfusion imaging (MPI) observed in patients without obstructive coronary artery disease (CAD). It is unclear whether reversible MPI defects detected in the absence of obstructive CAD represent underlying vascular pathology or are false-positive MPI results. Recent evidence suggests that coronary endothelial dysfunction might play a role in the pathogenesis of these defects. Methods and Results  We prospectively recruited 36 patients with chest discomfort, reversible abnormalities on MPI, and nonobstructive or absent CAD (stenosis <50% on coronary angiography). The control group (n = 55) consisted of patients with chest discomfort and similar cardiac risk factors but with normal MPI findings. Vascular endothelial function was assessed in the brachial artery by ultrasound as the response to hyperemia and reported as percent flow-mediated dilation (FMD). Response to sublingual nitroglycerin was used as an indicator of endothelium-independent vasodilation. The patients with abnormal MPI findings and nonobstructive CAD had a significantly lower FMD (9.0% ± 7.2%), indicating endothelial dysfunction, compared with those with similar risk factors and normal MPI findings (12% ± 5.2%) (P ± .03). Baseline brachial artery size and endothelium-independent dilation were similar between groups. On multivariate analysis, only endothelial dysfunction was predictive of reversible MPI defects. Conclusions  Patients with chest pain and reversible MPI defects but without obstructive CAD have lower FMD indicative of endothelial dysfunction, as compared with similar patients with normal MPI findings. The possibility of a causal link between reversible MPI defects and endothelial dysfunction needs further exploration. Dr Soman was funded by the Herbert J. Levine Foundation Fellowship in Cardiovascular Medicine at Tufts-New England Medical Center and the Kos Pharmaceutical Fellowship in Preventive Cardiology during the course of this project.     

肾动脉纤维肌层发育不良的高分辨力三维增强MR血管成像

目的:评价高分辨力三维增强磁共振血管成像术(3D CE MRA)诊断肾动脉纤维肌层发育不良(FMD)的价值.方法:5例经临床和DSA造影确诊的肾动脉FMD患者行肾动脉高分辨力3D CE MRA检查,扫描同时使用透视触发和并行采集技术.分析所有患者的肾动脉和FMD显示情况,并与DSA对照.结果:肾动脉3D CE MRA清楚显示5例患者10支肾动脉主干及其近端段级分支,且静脉均未显影或显影很淡.5例FMD均为单侧肾动脉受累,2例表现为肾动脉主干和近端段级分支串珠状改变,3例表现为肾动脉中段局限性狭窄.3D CE MRA显示结果与DSA一致.结论:高分辨力肾动脉3D CE MRA能较好检出肾动脉主干和近端分支的FMD.     

Comparison of particle penetration with non-spherical polyvinyl alcohol versus trisacryl gelatin microspheres in women undergoing premyomectomy uterine artery embolization

AIM: The purpose of this study was to compare the depth of vascular penetration of non-spherical polyvinyl alcohol (PVA) versus trisacryl gelatin microspheres (MS) in women undergoing uterine artery embolization (UAE) immediately before transabdominal myomectomy. MATERIALS AND METHODS: A total of 17 patients who had been referred for embolization before myomectomy underwent bilateral uterine artery embolization using either 355-500 microm PVA (group A) or 700-900 microm MS (group B). The depth of penetration of the particles was assessed by identifying their presence and location in the resected specimen. RESULTS: Of the 17 women enrolled in this study, 10 were in group A and 6 in group B. One woman underwent embolization using both types of particle and was excluded from the analysis. Embolic particles were significantly (p = 0.048) more frequently located within the fibroid (4/6, 67%) in Group B than Group A (1/10, 10%). Particles were also identified in the perifibroid tissues in 4/6 (67%) in Group B and 4/10 (40%) in Group A, with no statistical difference. There were no procedural complications. CONCLUSION: MS particles (700-900 microm) penetrate significantly deeper into leiomyomata compared with non-spherical PVA (355-500 microm). MS may therefore confer advantages in UAE, as they may more specifically target the fibroid, allowing an earlier end-point to embolization and minimizing ischaemic damage to normal myometrium and ovaries.     

Attenuation-corrected thallium-201 single-photon emission tomography using a gadolinium-153 moving line source: clinical value and the impact of attenuation correction on the extent and severity of perfusion abnormalities

The aim of the study was to test the clinical value of attenuation-corrected (AC) thallium-201 single-photon emission tomography using a moving gadolinium-153 line source in a group of patients in whom coronary angiography was planned because of clinically suspected coronary artery disease (CAD). Furthermore, we wanted to test the impact of AC on assessment of the extent and severity of perfusion abnormalities. A total of 107 patients planned to undergo coronary angiography were included in the study. In each patient, AC and NC (non-corrected) ²⁰¹Tl SPET was performed. AC and NC images were evaluated visually as well as by a 31-segment semiquantitative analysis and the findings were correlated with angiographic results. Patients were assigned to two groups: group A with angina and no previous cardiac infarction or intervention and group B with known CAD because of previous myocardial infarction or intervention. With visual analysis, NC revealed a sensitivity of 88.9% in group A and 74.3% in group B, compared to 94.4% in group A and 94.3% in group B with AC. Specificity for NC was calculated to be 68.7% for group A and 91.3% for group B. AC demonstrated significantly higher specificity of 83.9% and 100%, respectively. This effect was particularly demonstrated for males and bicycle workload. The extent and severity of perfusion abnormalities were significantly influenced by the use of AC, in that significantly fewer abnormal and less severely abnormal segments were demonstrated in the segmental analysis as compared to NC; this was especially true for the vascular territory of the left anterior descending artery nd the right coronary artery. It is concluded that AC with a moving line source is feasible in patients with all degrees of probability of CAD. AC has a significant impact on the assessment of the severity and extent of myocardial ischaemia, especially in the posterior and septal wall. Received 23 September and in revised form 11 November 1997