Document Detail


Diagnosis of coronary artery disease in patients with permanent cardiac pacemaker by dobutamine stress echocardiography or exercise thallium-201 myocardial tomography.
MedLine Citation:
PMID:  11107204     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study evaluated the use of dobutamine stress echocardiography and exercise thallium-201 myocardial computed tomography (CT) in the diagnosis of coronary artery disease (CAD) in patients with permanent transvenous pacemaker with the electrode implanted in the right ventricle (RV). Twenty-nine consecutive patients with pacemaker underwent dobutamine stress echocardiography, exercise thallium-201 myocardial CT, and coronary arteriography over a period of 8 +/- 1 days. None of these patients had suffered a myocardial infarction (MI). The cardiac rhythm of every patient was electrically paced during echocardiography and tomography. Sixteen (55%) patients showed CAD on angiography (stenosis > or = 50% of the luminal diameter of a major epicardial vessel). The detection sensitivity for CAD was 94% for the tomography and 88% for the echocardiography (P = NS). The difference between the sensitivities of the two techniques in detecting CAD based on the affected coronary artery was not statistically significant. Of the 13 patients without CAD, tomography showed a positive result in nine cases, i.e., a specificity of 31%, whereas echocardiography showed a positive result in only one case, i.e., a specificity of 92% (P < 0. 01). Exercise thallium-201 myocardial computed tomography produces an increased rate of false-positive results in patients with permanent transvenous cardiac pacemaker (PCP) implanted in the right ventricle (RV). Dobutamine stress echocardiography can thus be used to reduce considerably the level of false-positive results in these patients and still retain a detection sensitivity for CAD equal to that of myocardial tomography.
Authors:
S Ciaroni; A Bloch; L Albrecht; B Vanautryve
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  17     ISSN:  0742-2822     ISO Abbreviation:  Echocardiography     Publication Date:  2000 Oct 
Date Detail:
Created Date:  2001-01-17     Completed Date:  2001-01-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  675-9     Citation Subset:  IM    
Affiliation:
Service de Cardiologie, Hôpital de la Tour, Meyrin_Genève, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Angiography*
Coronary Disease / diagnosis*,  radiography,  radionuclide imaging,  ultrasonography
Dobutamine / diagnostic use
Echocardiography*
Exercise Test
Female
Humans
Male
Middle Aged
Pacemaker, Artificial*
Risk Factors
Sensitivity and Specificity
Thallium Radioisotopes / diagnostic use
Tomography, Emission-Computed, Single-Photon*
Chemical
Reg. No./Substance:
0/Thallium Radioisotopes; 34368-04-2/Dobutamine

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


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