Document Detail


Diagnostic value of adenosine-induced left ventricular diastolic dysfunction for detecting coronary artery restenosis in patients undergoing stent implantation by Stress ECG-gated myocardial perfusion SPECT. A pilot study.
MedLine Citation:
PMID:  20966597     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Usefulness of diastolic dysfunction after adenosine stress for detecting coronary stenosis has not been defined. The diagnostic accuracy of a combination of myocardial perfusion and diastolic function, as defined by prolongation of time to peak-filling rate (TTPF)/R-R and myocardial perfusion alone for the detection of coronary restenosis, was evaluated.
METHODS AND RESULTS:  We used rest (201)Tl/ adenosine stress (99m)Tc-tetrofosmin myocardial perfusion singlephoton emission computed tomography (SPECT) in 70 patients. Patients were divided into the following 4 groups: 20 patients with normal SPECT without stent (Control group), 20 patients showing normal SPECT without coronary restenosis (Group 1), 16 patients showing significant coronary restenosis and myocardial ischemia (Group 2a) and 14 patients showing significant coronary restenosis without myocardial ischemia (Group 2b). The TTPF, which was calculated by quantitative gated SPECT (QGS)/R-R, was not different between after stress and at rest in Control group (0.18±0.02 vs 0.19±0.04, P=NS). The TTPF/R-R after stress was significantly lower than that at rest in Group 1 (0.17±0.02 vs 0.18±0.03, P<0.05), but TTPF/R-R after stress was significantly higher than that at rest in Groups 2a and 2b (0.22±0.03 vs 0.16±0.03, P<0.001 in Group 2a and 0.19±0.02 vs 0.16±0.02, P<0.001 in Group 2b, respectively). Diagnostic accuracy improved from 72% to 92% when prolongation of TTPF/R-R was taken into account (P<0.001).
CONCLUSIONS: Diastolic dysfunction after stress was an accurate marker for detecting significant restenosis following stent implantation.
Authors:
Yoshimochi Nakano; Naoya Matsumoto; Yasuyuki Suzuki; Masahiko Kato; Takaaki Miki; Jun Iida; Shunichi Yoda; Keiko Sugiyama; Yuichi Sato; Shu Kasama; Toshio Kushiro; Ken Nagao; Atsushi Hirayama
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2010-10-19
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  74     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-12-02     Completed Date:  2011-03-09     Revised Date:  2012-01-09    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  2658-65     Citation Subset:  IM    
Affiliation:
Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adenosine / administration & dosage*
Aged
Anti-Arrhythmia Agents / administration & dosage*
Coronary Restenosis / radiography*
Electrocardiography*
Exercise Test
Female
Humans
Male
Myocardial Reperfusion
Organophosphorus Compounds / administration & dosage
Organotechnetium Compounds / administration & dosage
Radiopharmaceuticals / administration & dosage
Stents*
Thallium Radioisotopes / diagnostic use
Tomography, Emission-Computed, Single-Photon*
Ventricular Dysfunction, Left* / chemically induced,  radiography
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 0/Organophosphorus Compounds; 0/Organotechnetium Compounds; 0/Radiopharmaceuticals; 0/Thallium Radioisotopes; 0/technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane; 58-61-7/Adenosine

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