Document Detail


Critical stenoses of the left anterior descending artery: predominant role in stress-induced pulmonary uptake of 201thallium.
MedLine Citation:
PMID:  7994667     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To relate the diagnostic finding of stress-induced pulmonary uptake of 201thallium to the severity and site of stenoses in specific coronary arteries. DESIGN: An ad hoc series of 525 referred cases had planar myocardial perfusion scintigraphy studies within four months of correlating invasive studies; patients who had previous revascularization procedures were excluded. MEASUREMENTS: Invasive studies were read by a cardiovascular radiologist with rating of stenoses as percentage luminal diameter, and grading of ventricular function from 1 (normal) to 5 (globally hypokinetic). Lung:myocardial ratios were quantitated independently on immediate poststress 201thallium myocardial perfusion images by a nuclear medicine physician. Multivariate regression equations were used to relate pulmonary uptake to stenoses in specific arteries and to the degree of ventricular dysfunction. RESULTS: Lung:myocardial ratios showed only a minor relationship to the number of subcritical (less than 90%) stenoses, but were considerably increased when severe (at least 90%) stenoses were present. Severe stenoses in the left anterior descending artery (LAD), particularly its proximal portion, provided the most dramatic increase in this index, modified by the contrast ventriculography score and to a lesser extent by additional stenoses at other sites. Regression analysis suggested a weighting of lesions in the LAD or left mainstem by a factor of at least 3 in comparison with the right coronary and left circumflex arteries. CONCLUSIONS: Stenoses in the LAD, particularly its proximal position, play a key role in the induction of increased pulmonary uptake of 201thallium on poststress scintigrams.
Authors:
G A Hurwitz; A C MacDonald
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  10     ISSN:  0828-282X     ISO Abbreviation:  Can J Cardiol     Publication Date:  1994 Dec 
Date Detail:
Created Date:  1995-01-19     Completed Date:  1995-01-19     Revised Date:  2008-04-09    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  982-8     Citation Subset:  IM    
Affiliation:
Department of Diagnostic Radiology/Nuclear Medicine, University of Western Ontario, London.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Coronary Angiography
Coronary Disease / diagnosis*,  physiopathology
Exercise Test / methods*
Female
Heart / radionuclide imaging
Humans
Lung / radionuclide imaging*
Male
Middle Aged
Myocardial Reperfusion
Regression Analysis
Thallium Radioisotopes / diagnostic use
Chemical
Reg. No./Substance:
0/Thallium Radioisotopes

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


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