| Comparing a High-dose Dipyridamole SPECT Imaging Protocol with Dobutamine and Exercise Stress Testing Protocols. Part III: Using Dobutamine to Determine Lung-to-Heart Ratios, Left Ventricular Dysfunction, and a Potential Viability Marker. | |
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MedLine Citation:
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PMID: 9826402 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Determination of the severity of coronary artery disease (CAD) by single photon emission computed tomography (SPECT) imaging has previously been shown to have greater sensitivity, specificity, and accuracy when performed with pharmacologic stress using dobutamine than by standard dose dipyridamole (SDD) or exercise stress testing (EST) prior to SPECT imaging. The use of lung to heart (L:H) ratios has been shown to be valuable in determining the presence or absence of left main (LM) or triple vessel (3V) CAD. No such work has been previously reported for dobutamine. Twenty-one patients were studied using dobutamine (n = 7) or EST (n = 14). These results were compared with results from Part II of this series of studies using high-dose dipyridamole (HDD) pharmacologic stress. In this study, patients underwent L:H ratio analysis following injection of 3 mCi of Tl-201, this provides sufficient time for thallium clearance from the blood pool. Results of the L:H ratios were compared with the results of coronary arteriographic (CA) evaluation. Patients who were "stressed" via EST demonstrated statistically greater (p </= 0.001) L:H ratios in patients with LM/3V CAD when compared with patients who had 0-2 significantly stenosed coronary arteries. Patients stressed with dobutamine demonstrated lower L:H ratios (p = NS) in patients with LM/3V CAD than was seen for patients with 0-2 V CAD. Patients stressed with dobutamine had statistically (p </= 0.05) lower L:H ratios than did similar patients stressed with EST. Increased L:H ratios following EST and HDD, as shown previously in Part II of this series, provide excellent markers for LM/3V CAD following Tl-201 injection. The presence of "normal" L:H ratios in patients with LM/3V CAD following dobutamine stress may suggest the presence of "stunned" or "hibernating" myocardium. The presence of "decreased" L:H ratios following dobutamine after HDD or EST has already shown an increased L:H ratio, might suggest a marker for myocardial viability that deserves further investigation. |
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Authors:
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Fleming; Feldmann; Fleming |
Publication Detail:
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Type: JOURNAL ARTICLE |
Journal Detail:
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Title: The International journal of angiology : official publication of the International College of Angiology, Inc Volume: 8 ISSN: 1615-5939 ISO Abbreviation: Int. J. Angiol. Publication Date: 1999 Jan |
Date Detail:
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Created Date: 1998-11-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9504821 Medline TA: Int J Angiol Country: - |
Other Details:
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Languages: ENG Pagination: 22-26 Citation Subset: - |
Affiliation:
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The Center for Clinical Cardiology and Research, Papillion, Nebraska, USA |
Export Citation:
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Descriptor/Qualifier:
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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