Rationale. The aim of our study was to investigate the myocardial perfusion deficit in rest images as compared to stress images in myocardial scintigraphy (MS).

Objectives. The aim of this study is to investigate the reverse perfusion (RP) pattern in MS.

Methods and Results. 263 patients were enrolled in the study (72 females and 191 males; mean age 65.7 ± 9.5 years old). Mean body mass index (BMI) was of 27.6 ± 3.8 Kg/m2. 115 patients were positive for a previous history of myocardial infarction (MI). 142 patients reported a revascularization treatment (percutaneous transluminal coronary angioplasty, PTCA, cardiac stent placement, coronary artery bypass grafting, CABG). All the patients underwent MS following standard single day Stress/Rest protocol.

In our series, 27 patients presented a RP pattern. We did not find statistically significant differences when considering age (p = 0.7988), sex (p = 0.0657), BMI (p = 0.8611), diabetes (p = 0.8259), dyslipidemia (p = 0.1464) or smoking status (p = 0.6829) in RP patients vs. non-RP patients. A history of MI is related to a RP pattern (p < 0.0001). A history of previous revascularization was not related with RP (p = 0.6868).

Discussion. The result of our study suggested that RP is probably related to artifacts of various origins. Further studies are necessary especially in microvascular dysfunction or a long history of disease.

Abbreviations: MS: myocardial scintigraphy, RR: reverse redistribution, RP: reverse perfusion, MI: myocardial infarction, CAD: coronary artery disease, CABG: coronary artery bypass grafting; PTCA: percutaneous transluminal coronary angioplasty; PCI: percutaneous coronary intervention, SPECT: single-photon emission computed tomogram.