High incidence of scintigraphic myocardial uptake defects at rest and during exercise in male elite runners

Objective-To evaluate the usefulness of myocardial perfusion scintigraphy (MIBI-SPECT) as a diagnostic tool in well trained men. Design-The study was prospective, involving 2 d stress-rest myocardial scintigraphy (MIBI-SPECT), polar map reconstruction with and without uniform attenuation correction, and comparison with a healthy male group (local Swedish) and with a commonly used reference group (American, Emery University Hospital). Setting-University Hospital, Stockholm, Sweden. Subjects-16 healthy, male elite runners (mean (SD) age 26.1 (3.1) years). Peak oxygen uptake 73 (4) ml O-2/kg/min. Results-Uptake defects on polar maps were found in the majority of the runners compared with both reference groups (local Swedish 13/16, American 10/16). Most defects (91%) were fixed. Defects were located in the anterior, lateral, and posterior regions of the left ventricle. Application of a uniform attenuation correction algorithm enhanced rather than reduced perfusion defect size, probably because this correction method is imperfect in SPECT studies of the thoracic cavity. Conclusions-If myocardial perfusion scintigraphy is used for evaluating well trained men, existing normal reference files for semiquantitative evaluation appear to be inadequate.