Document Detail


Safety and diagnostic accuracy of adenosine thallium-201 scintigraphy in patients unable to exercise and those with left bundle branch block.
MedLine Citation:
PMID:  1514488     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Three hundred forty consecutive patients (mean age 69 +/- 9 years) were evaluated with adenosine tomographic thallium-201 scintigraphy for suspected coronary artery disease. Minor side effects occurred in 91% of patients. Out of 28 patients (8%) with potentially serious side effects, 28 had significant atrioventricular (AV) block (second-degree, 24 patients; third-degree, four patients; syncope occurred in two patients). Acute bronchospasm and severe refractory angina pectoris occurred in one patient each. All side effects were transient and without sequelae. One hundred twenty-one patients underwent coronary angiography within 9 days of adenosine thallium imaging. The predictive accuracies of adenosine thallium imaging for identifying and localizing ischemia to a specific coronary distribution were: left anterior descending = 88%, left circumflex = 84%, right coronary = 88%. The predictive accuracy of adenosine thallium imaging in patients with left bundle branch block was 91%, and was higher than the 71% predictive accuracy noted in 39 patients who underwent exercise thallium testing (p = 0.04). It is concluded that adenosine thallium-201 myocardial scintigraphy was (1) highly accurate for the detection and localization of significant coronary artery disease; (2) it was more accurate at detecting ischemia in patients with left bundle branch block than exercise thallium testing, and (3) subjective side effects were common and were of no diagnostic importance; transient AV block occurred occasionally.
Authors:
J H O'Keefe; T M Bateman; R Silvestri; C Barnhart
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  124     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1992 Sep 
Date Detail:
Created Date:  1992-09-25     Completed Date:  1992-09-25     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  614-21     Citation Subset:  AIM; IM    
Affiliation:
Cardiovascular Consultants, Inc., Kansas City, MO 64111.
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MeSH Terms
Descriptor/Qualifier:
Adenosine / adverse effects,  diagnostic use*
Adult
Aged
Aged, 80 and over
Angina Pectoris / chemically induced
Bronchial Spasm / chemically induced
Bundle-Branch Block / complications*
Coronary Disease / complications,  physiopathology,  radionuclide imaging*
Exercise*
Exercise Test
Female
Heart / radionuclide imaging
Heart Block / chemically induced
Humans
Male
Middle Aged
Predictive Value of Tests
Sensitivity and Specificity
Thallium Radioisotopes / diagnostic use*
Vasodilator Agents / adverse effects,  diagnostic use
Chemical
Reg. No./Substance:
0/Thallium Radioisotopes; 0/Vasodilator Agents; 58-61-7/Adenosine

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


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