Document Detail

Stress-rest myocardial perfusion SPECT for functional assessment of coronary arteries with anomalous origin or course.
MedLine Citation:
PMID:  15073246     Owner:  NLM     Status:  MEDLINE    
Anomalous coronary arteries (ACAs) may be clinically silent and totally benign or associated with catastrophic and fatal presentations. It has been postulated that the proximal course of an ACA is a decisive factor in risk stratification and surgical approach. Particularly, a course between the aorta and pulmonary trunk carries a high risk of major adverse events. We sought to evaluate the anatomic course of documented ACAs by transesophageal echocardiography (TEE) and to study their functional importance using stress-rest (99m)Tc-sestamibi ((99m)Tc-MIBI) myocardial perfusion SPECT. METHODS: From a cohort of patients undergoing coronary angiography in our department between January 1997 and April 2003, we selected 14 with ACAs but without CAD (9 men and 5 women; mean age, 50.7 +/- 14.6 y). All patients underwent TEE and stress-rest (99m)Tc-MIBI myocardial perfusion SPECT. RESULTS: TEE correctly identified the origin of all ACAs and revealed an anomalous course between the great vessels in 5 patients. At exercise myocardial perfusion SPECT, 4 of 14 patients demonstrated a reversible myocardial perfusion defect. All these patients had an anomalous course between the aorta and pulmonary artery. CONCLUSION: In this study, 4 of 5 (80%) anomalous courses between the aorta and pulmonary artery were associated with the finding of a reversible perfusion defect on stress-rest SPECT. An integrated evaluation of anatomic course and hemodynamic importance could be useful in the management of ACA.
Leonardo De Luca; Francesco Bovenzi; Domenico Rubini; Artor Niccoli-Asabella; Giuseppe Rubini; Italo De Luca
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Validation Studies    
Journal Detail:
Title:  Journal of nuclear medicine : official publication, Society of Nuclear Medicine     Volume:  45     ISSN:  0161-5505     ISO Abbreviation:  J. Nucl. Med.     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-04-09     Completed Date:  2004-06-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0217410     Medline TA:  J Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  532-6     Citation Subset:  IM    
Department of Cardiology, Azienda Policlinico, Bari, Italy.
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MeSH Terms
Cohort Studies
Coronary Angiography
Coronary Vessel Anomalies / radiography,  radionuclide imaging*,  ultrasonography
Echocardiography, Transesophageal
Exercise Test
Middle Aged
Radiopharmaceuticals / diagnostic use
Reproducibility of Results
Sensitivity and Specificity
Technetium Tc 99m Sestamibi / diagnostic use*
Tomography, Emission-Computed, Single-Photon / methods*
Reg. No./Substance:
0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi

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