Document Detail


Comparison of exercise perfusion and ventricular function imaging: an analysis of factors affecting the diagnostic accuracy of each technique.
MedLine Citation:
PMID:  6319468     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Exercise thallium-201 perfusion scans and gated equilibrium blood pool scans were performed in 120 catheterized patients with a chest pain syndrome. Eighty-six patients had coronary artery disease and 34 patients did not. The effects of gender, propranolol, exercise level, exercise ischemia, history of typical angina, history of previous myocardial infarction, electrocardiographic Q waves, number of diseases vessels and extent of coronary artery obstruction on diagnostic accuracy were evaluated. The overall sensitivity and specificity of thallium scans were 76 and 68%, respectively, and those of gated blood pool scans 80 and 62% (p = not significant). Propranolol decreased the specificity of thallium scans (propranolol = 42%; no propranolol = 87%, p less than 0.05). Thallium scans and anginal history were less sensitive for detecting coronary disease in women (men: thallium = 79%; angina = 77%; women: 54 and 46%, respectively; p less than 0.05). Exercise level did not significantly affect the diagnostic accuracy of either scan. Thallium and gated scans were both highly sensitive (95%) in detecting disease in 20 patients with a prior myocardial infarction, angina and a positive electrocardiogram. The sensitivity of the thallium scan significantly decreased as the number of diseased vessels decreased. Both thallium and gated scans were less frequently positive in patients with atypical angina or no Q waves, but were not significantly influenced by electrocardiographic ischemia. The sensitivity and specificity of both scans were low in 57 patients with the combination of atypical angina, no history of infarction and equivocal stress electrocardiogram thallium = 61 and 63%, respectively; gated = 61 and 67%). When stress thallium scan evaluation included the electrocardiogram and thallium scan interpretation, the diagnostic accuracy was 81%. When all the information from gated scans (wall motion, ejection fraction, pulmonary blood volume) was combined for final gated scan evaluation, the diagnostic accuracy was 83%. When electrocardiographic data were added to all three gated scan variables, diagnostic accuracy was 77%. In conclusion, thallium perfusion and gated blood pool scans have reasonable diagnostic accuracy for coronary artery disease in a group of patients with a moderately high prevalence of disease. However, combined variables from each test are needed to provide reliable diagnostic accuracy.
Authors:
M D Osbakken; R D Okada; C A Boucher; H W Strauss; G M Pohost
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  3     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1984 Feb 
Date Detail:
Created Date:  1984-03-05     Completed Date:  1984-03-05     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  272-83     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Coronary Circulation
Coronary Disease / radionuclide imaging*
Electrocardiography
Erythrocytes
Exercise Test
Female
Heart / radionuclide imaging*
Humans
Male
Middle Aged
Physical Exertion
Propranolol / pharmacology
Radioisotopes / diagnostic use*
Sex Factors
Sodium Pertechnetate Tc 99m
Stroke Volume
Technetium / diagnostic use*
Thallium / diagnostic use*
Grant Support
ID/Acronym/Agency:
1-T32 HL-07416/HL/NHLBI NIH HHS; HL21751/HL/NHLBI NIH HHS; HL26215/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Radioisotopes; 23288-60-0/Sodium Pertechnetate Tc 99m; 525-66-6/Propranolol; 7440-26-8/Technetium; 7440-28-0/Thallium

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


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