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    
Abstract/OtherAbstract:
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.
Authors:
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    
Affiliation:
Department of Cardiology, Azienda Policlinico, Bari, Italy. leodeluca@virgilio.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cohort Studies
Coronary Angiography
Coronary Vessel Anomalies / radiography,  radionuclide imaging*,  ultrasonography
Echocardiography, Transesophageal
Exercise Test
Female
Humans
Male
Middle Aged
Radiopharmaceuticals / diagnostic use
Reproducibility of Results
Sensitivity and Specificity
Technetium Tc 99m Sestamibi / diagnostic use*
Tomography, Emission-Computed, Single-Photon / methods*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi

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


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