Resumen

VALDES MARTIN, Alexander  y  SIXTO FERNANDEZ, Sherien. Microvascular angina in postmenopausal women. Medisur [online]. 2011, vol.9, n.5, pp. 443-451. ISSN 1727-897X.

Background: Microvascular angina is common in postmenopausal women. Myocardial ischemia has been induced by stress testing, which has proved a relationship between endothelial dysfunction and myocardial perfusion defects. Objective: To determine whether myocardial ischemia can be evidenced by abnormalities of perfusion and function detected by myocardial scintigraphy in women with typical angina, normal coronary angiography and endothelial dysfunction. Methods: A descriptive study was conducted at the Cardiology and Cardiovascular Surgery Institute in Havana. These women were tested for lipid profile. Endothelial function was measured in the brachial artery by ultrasound, and a 24 hours (Holter) lectrocardiographic study. A stress-rest protocol during scan was used. Patients were divided into two groups according to presence (group I) or absence (group II) of myocardial perfusion defects. Results: 21 patients presented perfusion defects. In group I, 57% of patients presented more endothelial dysfunction. Only twelve patients showed reversible defects of perfusion and 75% of these cases were associated with a reduction in left ventricular ejection fraction of post-stress over 5% and regional abnormalities of wall motion. Three patients in group I showed evidence of ischemia compared to four others in group II. Conclusions: Stress-induced ischemia is associated with a post-stress reduction in left ventricular ejection fraction and an abnormal endothelium-dependent vasodilation.

Palabras clave : miocardial ischemia; stress, physiological; exercise test; stroke volume; vasodilation.