The effect of exercise on the parameters of the scintigraphy of the myocardium with labelled pyrophosphate was studied in 35 patients with coronary heart disease and angina of effort and at rest with regard to the activity of the pituitary-adrenal cortex system. The functional status of this system was evaluated on the basis of data on the blood changes in somatotrophic hormone and cortisol. The use of a scoring system made it possible to identify four types of the pattern of the scintigraphic parameters. Type I and II of the pattern of the scintigraphic parameters indicating the normal ratios between the requirements of the cardiac muscle in oxygen and myocardial perfusion were characteristic of the patients with angina pectoris in the presence of an increased activity of the pituitary-adrenal cortex system. When the coronary heart disease patients with angina had a lower activity of this system, the authors more frequently recorded types III and IV of the pattern of scintigraphy which reflected a decreased perfusion and myocardial damage during exercise.
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