Document Detail

Prevalence of and variables associated with silent myocardial ischemia on exercise thallium-201 stress testing.
MedLine Citation:
PMID:  2358586     Owner:  NLM     Status:  MEDLINE    
The prevalence of silent myocardial ischemia was prospectively assessed in a group of 103 consecutive patients (mean age 59 +/- 10 years, 79% male) undergoing symptom-limited exercise thallium-201 scintigraphy. Variables that best correlated with the occurrence of painless ischemia by quantitative scintigraphic criteria were examined. Fifty-nine patients (57%) had no angina on exercise testing. A significantly greater percent of patients with silent ischemia than of patients with angina had a recent myocardial infarction (31% versus 7%, p less than 0.01), had no prior angina (91% versus 64%, p less than 0.01), had dyspnea as an exercise test end point (56% versus 35%, p less than 0.05) and exhibited redistribution defects in the supply regions of the right and circumflex coronary arteries (50% versus 35%, p less than 0.05). The group with exercise angina had more ST depression (64% versus 41%, p less than 0.05) and more patients with four or more redistribution defects. However, there was no difference between the two groups with respect to mean total thallium-201 perfusion score, number of redistribution defects per patient, multi-vessel thallium redistribution pattern or extent of angiographic coronary artery disease. There was also no difference between the silent ischemia and angina groups with respect to antianginal drug usage, prevalence of diabetes mellitus, exercise duration, peak exercise heart rate, peak work load, peak double (rate-pressure) product and percent of patients achieving greater than or equal to 85% of maximal predicted heart rate for age. Thus, in this study group, there was a rather high prevalence rate of silent ischemia (57%) by exercise thallium-201 criteria.(ABSTRACT TRUNCATED AT 250 WORDS)
C M Gasperetti; L R Burwell; G A Beller
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  16     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1990 Jul 
Date Detail:
Created Date:  1990-07-31     Completed Date:  1990-07-31     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  115-23     Citation Subset:  AIM; IM    
Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville 22908.
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MeSH Terms
Angina Pectoris / epidemiology
Coronary Angiography
Coronary Disease / epidemiology*,  physiopathology,  radionuclide imaging
Exercise Test*
Middle Aged
Myocardial Infarction / epidemiology
Prospective Studies
Thallium Radioisotopes / diagnostic use*
Grant Support
Reg. No./Substance:
0/Thallium Radioisotopes

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

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