To evaluate the clinical significance of reverse redistribution (RR) of res
ting Tl-201 Single photon emission computed tomography (SPECT) in patients
with vasospastic angina (VSA), we performed left ventriculography, coronary
angiography and resting Tl-201-SPECT in 22 patients with VSA. Left ventric
ulography showed abnormal wall motion in 17 of 22 patients (77%) and 37 of
154 segments. Thirty-one of these 37 segments (84%) were within the area pe
rfused by coronary arteries showing acetylcholine-induced vasospasm. On Tl-
201 images, abnormal findings were observed in 11 of 22 patients (50%), and
among them, 7 patients (32%) had RR. Seven of 37 segments (19%) having abn
ormal regional wall motion had RR of Tl-201, and in 6 of these 7 segments (
86%), accumulation of I-123-BMIPP was found to be reduced.
We conclude that repetitive brief myocardial ischemia may cause myocardial
injuries in patients with VSA, and that the presence of RR of Tl-201 indica
tes the presence of myocardial injury in these patients.