Document Detail

Clinical correlation between increased lung to heart ratio of technetium-99m sestamibi and multivessel coronary artery disease.
MedLine Citation:
PMID:  15882667     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: An increased lung to heart ratio (LHR) on thallium-201 (Tl-201) stress myocardial perfusion imaging (MPI) is a predictor of adverse cardiac events and identifies people with extensive coronary artery disease (CAD). The implications of increased LHR in patients undergoing stress technetium-99m (tc-99m) sestamibi are developing. Our aim is to evaluate the relationship between increased LHR and extent of CAD in patients undergoing tc-99m sestamibi MPI. METHODS: We reviewed the records and images of 530 consecutive subjects who underwent exercise or adenosine tc-99 m sestamibi MPI. One hundred thirty-two had transient or partially reversible myocardial perfusion defects and 79 (exercise=34, adenosine=45, male=43, female=36, mean age=61 years) of these underwent coronary angiography (study population). The average LHR of these 79 subjects was compared to 79 patients (control population) with normal scans (exercise=50, adenosine=29, male=34, female=45, mean age=60 years). RESULTS: The mean LHR (+/-SE) in subjects with normal scans was 0.30+/-0.01. The mean LHR for those with abnormal scans and single vessel CAD who underwent exercise was 0.32+/-0.01 and pharmacological stress was 0.31+/-0.01. There was no statistically significant difference between the LHR of those with a normal scan and those with single vessel disease and an abnormal scan. However, there was a statistically significant association between the elevated LHR and multi-vessel CAD. The mean LHR for subjects with multi-vessel CAD with exercise was 0.39+/-0.01 (p=0.000) and for adenosine was 0.39+/-0.02 (p=0.000). CONCLUSION: An elevated LHR in patients undergoing exercise or pharmacological tc-99m MPI correlates with multi-vessel CAD.
Shekar P Kumar; Stacy D Brewington; Kevin F O'Brien; Assad Movahed
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  101     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-05-10     Completed Date:  2005-09-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  219-22     Citation Subset:  IM    
Section of Cardiology, Department of Internal Medicine, PCMH Teaching annex #378, East Carolina University Brody School of Medicine, Greenville, NC 27858-4354, USA.
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MeSH Terms
Adenosine / diagnostic use
Coronary Artery Disease / metabolism*,  physiopathology,  radionuclide imaging
Coronary Circulation / physiology
Exercise Test
Lung / metabolism*
Middle Aged
Myocardium / metabolism*
Radiopharmaceuticals / pharmacokinetics*
Retrospective Studies
Severity of Illness Index
Technetium Tc 99m Sestamibi / pharmacokinetics*
Vasodilator Agents / diagnostic use
Reg. No./Substance:
0/Radiopharmaceuticals; 0/Vasodilator Agents; 109581-73-9/Technetium Tc 99m Sestamibi; 58-61-7/Adenosine

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