Document Detail


Assessment of transient left ventricular dilatation on rest and exercise on Tc-99m tetrofosmin myocardial SPECT.
MedLine Citation:
PMID:  11805482     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In myocardial perfusion imaging, multiple-vessel involvement of coronary artery disease (CAD) sometimes makes diagnosis difficult. Transient left ventricular (LV) dilatation on Tl-201 myocardial SPECT is a useful finding that enables the clinician to identify patients with multiple-vessel disease. The aim of this study was to confirm the utility of measuring transient LV dilatation for the detection of multiple-vessel CAD in exercise Tc-99m tetrofosmin myocardial SPECT. The participants were 55 CAD patients and 20 controls who underwent Tc-99m tetrofosmin myocardial SPECT exercise and resting imaging. During exercise, 370 MBq (10 mCi) Tc-99m tetrofosmin was injected. Exercise images were obtained 30 minutes after injection. At 210 minutes after injection, 740 MBq (20 mCi) Tc-99m tetrofosmin was administered intravenously. The rest SPECT images were acquired 30 minutes later. Thirty-six radii at every 10 degrees were generated from the center of short-axis images. An area surrounded by 36 maximal points of the myocardial Tc-99m tetrofosmin counts on each radius was calculated for exercise and rest images. The area surrounded by the 36 maximal points in the same slice of the exercise and rest images was assigned the variables A (Ex) and A(R), respectively. The transient dilatation index (TDI) of the left ventricle was calculated using the formula mean A (Ex)/A(R) in the apical, middle, and basal myocardial short-axis images. In the controls, the TDI was 0.970 +/- 0.021. In patients with CAD, the TDIs of one-vessel disease, two-vessel disease, and three-vessel disease were 1.034 +/- 0.032, 1.093 +/- 0.046, and 1.131 +/- 0.076, respectively. The TDIs were significantly greater in patients who had more occluded coronary arteries (P < 0.01). If the mean + 2SD of the TDI (1.012) in controls were assumed to be the normal upper limit, the sensitivity, specificity, and accuracy of this method in detecting two-vessel or three-vessel disease would be 91.4%, 76.9%, and 84%, respectively. The TDI is a useful index for evaluating subendocardial ischemia non-invasively and detecting multiple-vessel disease clinically.
Authors:
Noriyuki Kinoshita; Hiroki Sugihara; Yoshihiko Adachi; Tomoki Nakamura; Akihiro Azuma; Yoshio Kohno; Masao Nakagawa
Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Clinical nuclear medicine     Volume:  27     ISSN:  0363-9762     ISO Abbreviation:  Clin Nucl Med     Publication Date:  2002 Jan 
Date Detail:
Created Date:  2002-01-28     Completed Date:  2002-05-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7611109     Medline TA:  Clin Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  34-9     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Kyoto First Red Cross Hospital, Japan. nkinoshi@pearl.ocn.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Coronary Angiography
Coronary Artery Disease / physiopathology,  radiography,  radionuclide imaging*
Dilatation, Pathologic / radionuclide imaging
Exercise* / physiology
Female
Hemodynamics
Humans
Hypertrophy, Left Ventricular / physiopathology,  radionuclide imaging
Image Interpretation, Computer-Assisted
Male
Middle Aged
Organophosphorus Compounds / diagnostic use
Organotechnetium Compounds / diagnostic use
Radiopharmaceuticals / diagnostic use
Rest
Sensitivity and Specificity
Signal Processing, Computer-Assisted
Tomography, Emission-Computed, Single-Photon
Ventricular Dysfunction, Left / physiopathology,  radionuclide imaging*
Ventricular Remodeling* / physiology
Chemical
Reg. No./Substance:
0/Organophosphorus Compounds; 0/Organotechnetium Compounds; 0/Radiopharmaceuticals; 0/technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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