Assessment of Relation of Personality Types With The Prevalence of Exercise-Induced Silent Ischemia and Myocardial Ischemic Burden by TI-201 Scintigraphy in Patients with Coronary Artery Disease

Type A patients with coronary artery disease (CAD) tend to ignore symptoms or underreport angina during challenging tasks such as the treadmill exercise test. This study sought to evaluate whether type A patients with CAD might be more likely than type B patients to have silent ischemia during exercise and also greater ischemic burden by TI-201 scintigraphy. 112 patients with angiographically defined CAD and a positive treadınili exercise test were studied. All patients underwent exercise TI-201 SPECT imaging and a psychologica1 test (SCL-90) to asses type A personality. Scintigraphic images were divided into 20 segments and the number of redistribution and fixed defects were calculated in each patient. 78 patients were of type A and 34 patients were of type B according to psychological testing. 40 type A patients (51%) and 25 type B (73%) patients report ed typical angina during exercise. Type A patients were more likely to have silent ischemia than type B patients (p<0.05). However, when patients were classified as type A plus symptomatic ischemia, type A plus silent ischemia, type B plus symptomatic ischemia and type B plus silent ischemia into four subgroups, the number of redistribution defects as an indicator of myocardial ischemic burden were 3.64±2.4, 3.42±2.2, 3.28±1.9, 3.46±2.6, respectively. There were no significant differences among them. In conclusion, although type A patients were more likely to have silent ischemia than type B patients during exercise, there was no significant difference with regard to ischemic burden among CAD patients classified according to their personality types and presence of symptoms during exercise.