Document Detail

Preoperative diagnosis of coronary artery disease in patients with valvular heart disease using technetium-99m isonitrile tomographic imaging together with high-dose dipyridamole and handgrip exercise.
MedLine Citation:
PMID:  1590234     Owner:  NLM     Status:  MEDLINE    
Forty-seven consecutive patients (mean age 61 +/- 8 years) referred for cardiac catheterization due to moderate to severe aortic (n = 30) or mitral (n = 17) valvular heart disease were examined by technetium-99m isonitrile tomography together with a high-dose dipyridamole infusion (0.7 mg/kg) and handgrip stress. Tomography did not identify coronary artery disease (CAD) in 3 of the 21 patients with angiographically proven disease (sensitivity 86%) and suggested false positive results in 5 of the 26 without the disease (specificity 81% and negative predictive accuracy 88%). No patient without angina pectoris and with negative scintigraphy (n = 14) had angiographically significant (greater than or equal to 50% diameter stenosis) CAD. Overall vessel sensitivity was 63%, and specificity was 92%. The frequency of side effects during the dipyridamole-handgrip test was only 7%. No serious complications occurred during stress tests. Thus, technetium-99m isonitrile tomographic imaging, together with high-dose dipyridamole and handgrip exercise, is a useful noninvasive method in excluding significant CAD in patients with valvular heart disease.
R Kettunen; H V Huikuri; J Heikkilä; J T Takkunen
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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:  69     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1992 Jun 
Date Detail:
Created Date:  1992-06-24     Completed Date:  1992-06-24     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:  1442-5     Citation Subset:  AIM; IM; S    
Department of Medicine, Oulu University Central Hospital, Finland.
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MeSH Terms
Coronary Angiography
Coronary Disease / complications,  radiography,  radionuclide imaging*
Dipyridamole / adverse effects,  diagnostic use*
Exercise Test* / adverse effects
Heart Valve Diseases / complications*,  surgery
Middle Aged
Nitriles / diagnostic use*
Organotechnetium Compounds / diagnostic use*
Predictive Value of Tests
Sensitivity and Specificity
Technetium Tc 99m Sestamibi
Tomography, Emission-Computed*
Reg. No./Substance:
0/Nitriles; 0/Organotechnetium Compounds; 109581-73-9/Technetium Tc 99m Sestamibi; 58-32-2/Dipyridamole

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