Document Detail


Comparison of treadmill exercise versus dipyridamole stress with myocardial perfusion imaging using rubidium-82 positron emission tomography.
MedLine Citation:
PMID:  15837254     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study assessed the feasibility of treadmill exercise rubidium-82 ((82)Rb) positron emission tomography (PET) and compared image quality and diagnostic content with dipyridamole (82)Rb PET in patients referred for evaluation of coronary artery disease (CAD). BACKGROUND: Dipyridamole stress (82)Rb PET myocardial perfusion imaging (MPI) is an accurate imaging modality used to diagnose CAD and determine prognosis. Although pharmacologic stress is used routinely, exercise treadmill stress may be an alternative and provide clinical information helpful to decision making, particularly for patients unwilling or unable to tolerate pharmacologic stress. METHODS: Fifty patients (mean age, 60 +/- 10 years; 47 men) underwent treadmill exercise and dipyridamole (82)Rb PET. Images were assessed: 1) qualitatively using a 17-segment model and a semiquantitative visual score on a five-point scale and with calculation of summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS); and 2) quantitatively with a 70% threshold for abnormal perfusion and expressed as extent of abnormal perfusion (% left ventricular). RESULTS: Treadmill exercise was preferred by 74% of patients (37 of 50, p < 0.001). The exercise and dipyridamole (82)Rb PET summed scores and quantitative extent of abnormal perfusion were very similar and highly correlated. Results of Bland-Altman analysis showed no significant bias. Image quality was superior with exercise stress with greater myocardial uptake and higher target to background ratios. CONCLUSIONS: Treadmill exercise (82)Rb PET is feasible and provides imaging results of similar diagnostic content and superior image quality compared with dipyridamole stress. Treadmill exercise is a reasonable alternative to pharmacologic stress with (82)Rb PET MPI.
Authors:
Benjamin J W Chow; Karthikeyan Ananthasubramaniam; Robert A dekemp; Mary M Dalipaj; Rob S B Beanlands; Terrence D Ruddy
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  45     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-04-19     Completed Date:  2005-05-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1227-34     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Coronary Circulation / physiology*
Coronary Disease / radionuclide imaging*
Dipyridamole / diagnostic use*
Electrocardiography
Exercise Test*
Female
Humans
Male
Middle Aged
Patient Satisfaction
Positron-Emission Tomography / methods*
Prognosis
Prospective Studies
Rubidium Radioisotopes / diagnostic use
Vasodilator Agents / diagnostic use*
Chemical
Reg. No./Substance:
0/Rubidium Radioisotopes; 0/Vasodilator Agents; 58-32-2/Dipyridamole

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


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