Document Detail

Combined exercise radionuclide angiocardiography and single photon emission computed tomography perfusion studies for assessment of coronary artery disease.
MedLine Citation:
PMID:  1948112     Owner:  NLM     Status:  MEDLINE    
Although there is widespread use of exercise thallium 201 scintigraphy and radionuclide angiocardiography in patients with coronary artery disease (CAD), little is known about the independence, concordance, or relative importance of these studies in the diagnosis, prognosis, and assessment of the outcome of therapy. The use of both tests in the same patient has been impractical because of the logistic considerations imposed by two exercise tests on separate days, and excessive radiation exposure. New technetium 99m-labeled radiopharmaceuticals with high myocardial extraction now permit the simultaneous assessment of myocardial perfusion (single photon emission computed tomography [SPECT]) and ventricular function (radionuclide angiocardiography [RNA]) during treadmill exercise (exercise tolerance test [ETT]). The ability to perform all three tests during a single exercise session offers a very attractive technique to evaluate patients with CAD. The investigators studied 86 patients with chronic CAD using the same-day perfusion and function protocol combined with treadmill exercise. The results demonstrate good concordance between myocardial perfusion and ventricular function as indicated by a significant correlation between tomographic perfusion defect size and ejection fraction (P less than .0001, R = 0.75 at rest and P less than .0001, R = 0.76 during exercise). Stepwise logistic regression was used to model ETT, RNA, and SPECT variables against the presence of one or more 60% stenoses by quantitative angiography, an end point present in 47 patients. Univariable analysis showed all three tests (ETT, RNA, and SPECT) to be significant predictors of the end points (lambda 2 = 5.1, P less than .05; lambda 2 = 12.5, P less than .001; and lambda 2 = 16.1, P less than .001, respectively). Multivariable analysis demonstrated that SPECT provided more diagnostic information than ETT and RNA (Lambda 2 = 16.1, P less than .001).(ABSTRACT TRUNCATED AT 250 WORDS)
S Borges-Neto; R E Coleman; J M Potts; R H Jones
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Seminars in nuclear medicine     Volume:  21     ISSN:  0001-2998     ISO Abbreviation:  Semin Nucl Med     Publication Date:  1991 Jul 
Date Detail:
Created Date:  1991-11-27     Completed Date:  1991-11-27     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  1264464     Medline TA:  Semin Nucl Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  223-9     Citation Subset:  IM    
Department of Surgery, Duke University Medical Center, Durham, NC 27710.
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MeSH Terms
Coronary Disease / radionuclide imaging*
Exercise Test*
Heart / radionuclide imaging*
Radionuclide Angiography*
Tomography, Emission-Computed, Single-Photon*
Comment In:
Semin Nucl Med. 1991 Jul;21(3):170-2   [PMID:  1835135 ]

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

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