Document Detail

Noninvasive prediction of multivessel disease after myocardial infarction.
MedLine Citation:
PMID:  7408145     Owner:  NLM     Status:  MEDLINE    
In 65 patients with a previous transmural myocardial infarction (anterior in 33, inferior in 32), exercise thallium scanning was compared with 12-lead exercise electrocardiography to see if multivessel disease could be detected. At coronary arteriography 40 patients were shown to have multivessel disease ( greater than or equal to 70% diameter stenosis in two or three vessels) and 25 patients had one-vessel disease. On the exercise scan thallium defects corresponding to the electrocardiographic site of infarction were present in all patients. Patients wih one-vessel and multivessel disease were separated by exercise-induced angina, perfusion defects on the exercise thallium scan in more than one specific vasculare area, and a positive exercise ECG associated with angina, but not by a positive exercise ECG alone. Of the 40 patients with multivessel disease, 85% had defects in more than one vascular area on the thallium scan and 70% had a positive exercise ECG (p = NS). Of the 37 patients with thallium defects in more than one specific vascular area, 92% had multivessel disease, compared with 72% of the 39 patients who had a positive exercise ECG (p < 0.05). periinfactional ischemia was present in 38 of the 65 patients (58%) ( 14 of 25 with one-vessel disease and 24 of 40 with multivessel disease), and did not correlate with the severity of the corresponding coronary artery disease. When thallium defects that resolved were noted in a second vascular area, they were associated with a resolving rather than a constant defect in the vascular area where the infarction had occurred ( p < 0.005). In patients after a transmural myocardial infarction, multivessel disease can be better differentiated from one-vessel disease by thallium scanning than by exercise electrocardiography.
R F Dunn; B Freedman; I K Bailey; R Uren; D T Kelly
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  62     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1980 Oct 
Date Detail:
Created Date:  1980-11-24     Completed Date:  1980-11-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  726-34     Citation Subset:  AIM; IM    
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MeSH Terms
Angina Pectoris / etiology
Coronary Disease / complications,  diagnosis*,  radionuclide imaging
Exercise Test
Middle Aged
Myocardial Infarction / complications*
Thallium / diagnostic use
Reg. No./Substance:
0/Radioisotopes; 7440-28-0/Thallium

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

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