Document Detail

Improved specificity of myocardial thallium-201 single-photon emission computed tomography in patients with left bundle branch block by dipyridamole.
MedLine Citation:
PMID:  1872279     Owner:  NLM     Status:  MEDLINE    
Reduced septal uptake of thallium-201 during exercise is frequently observed in patients with left bundle branch block (LBBB) and normal coronary arteries. This may reflect normal coronary autoregulation in response to lower septal oxygen demand; thus, dipyridamole, which uniformly exploits flow reserve, would be more accurate for diagnosis of coronary artery disease (CAD). Sixteen patients with LBBB underwent exercise and dipyridamole thallium-201 single-photon emission computed tomography and coronary angiography within 3 months. Sensitivity for detection of left anterior descending CAD (greater than 50% stenosis) was 0.83 for exercise and 1.00 for dipyridamole. Specificity was 0.30 (visual) or 0.20 (quantitative analysis) for exercise and 0.80 (visual) or 0.90 (quantitative) for dipyridamole (p less than 0.05). Dipyridamole combined with quantitative analysis also improved specificity of CAD detection overall (p less than 0.01). These data demonstrate that pharmacologic vasodilation is more accurate than exercise when diagnosing CAD by myocardial perfusion scintigraphy in patients with LBBB.
R J Burns; L Galligan; L M Wright; S Lawand; R J Burke; P J Gladstone
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  68     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1991 Aug 
Date Detail:
Created Date:  1991-09-13     Completed Date:  1991-09-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  504-8     Citation Subset:  AIM; IM    
Department of Medicine, Toronto Hospital, Ontario, Canada.
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MeSH Terms
Bundle-Branch Block / complications*
Coronary Angiography
Coronary Disease / etiology,  radionuclide imaging*
Dipyridamole / diagnostic use*
Exercise Test
False Positive Reactions
Middle Aged
Sensitivity and Specificity
Thallium Radioisotopes / diagnostic use*
Tomography, Emission-Computed, Single-Photon*
Reg. No./Substance:
0/Thallium Radioisotopes; 58-32-2/Dipyridamole

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

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