Document Detail


Submaximal exercise thallium-201 SPECT for assessment of interventional therapy in patients with acute myocardial infarction.
MedLine Citation:
PMID:  1901189     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Submaximal thallium-201 stress testing has been shown to provide important diagnostic and prognostic information in patients with acute myocardial infarction. The purpose of this investigation was to evaluate the diagnostic value of early submaximal stress testing and thallium-201 single photon emission computed tomography (SPECT) after interventional therapy. Scintigraphic results from 56 patients with infarctions, who underwent acute thrombolytic therapy, angioplasty, or both, were compared with late (6 weeks) functional outcome as assessed by radionuclide ventriculography and with results of discharge coronary angiography. A linear correlation was found between the extent of thallium-201 SPECT perfusion defect and late ventricular function (r = 0.74, p less than 0.01). Forty-two percent of patients with large SPECT perfusion defects had normal left ventricular ejection fractions, suggesting an overestimation of infarct size by early imaging. Sensitivity and specificity of thallium-201 SPECT for detection of coronary artery stenosis in noninfarct territories was 57% and 46%, respectively, indicating limited diagnostic definition of extent of underlying coronary artery disease. Results of follow-up coronary angiography showed a significant relationship between the size of the initial perfusion defect and early restenosis or reocclusion of the infarct artery. Thus the extent of early thallium-201 perfusion defects correlates with late functional outcome but appears to overestimate the degree of injury. Submaximal thallium-201 stress testing allows only limited characterization of underlying coronary artery disease. Early assessment of infarct size may identify a patient population at high risk for reocclusion of the infarct artery.
Authors:
R E Stewart; N Kander; J E Juni; S G Ellis; W W O'Neill; M A Schork; E J Topol; M Schwaiger
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  121     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1991 Apr 
Date Detail:
Created Date:  1991-05-02     Completed Date:  1991-05-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1033-41     Citation Subset:  AIM; IM    
Affiliation:
Division of Nuclear Medicine, University of Michigan Medical Center, Ann Arbor 48109-0028.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Coronary Angiography
Exercise Test / methods*
Female
Gated Blood-Pool Imaging
Heart Catheterization
Humans
Male
Middle Aged
Myocardial Infarction / drug therapy,  epidemiology,  radionuclide imaging*
Prognosis
Recombinant Proteins / therapeutic use
Recurrence
Retrospective Studies
Thallium Radioisotopes / diagnostic use*
Thrombolytic Therapy
Tissue Plasminogen Activator / therapeutic use
Tomography, Emission-Computed, Single-Photon / methods*
Chemical
Reg. No./Substance:
0/Recombinant Proteins; 0/Thallium Radioisotopes; EC 3.4.21.68/Tissue Plasminogen Activator

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


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