Document Detail


A comparison of dobutamine and maximal exercise as stress for thallium scintigraphy.
MedLine Citation:
PMID:  8491224     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In the assessment and evaluation of patients with suspected coronary artery disease there is a need for pharmacological stress combined with thallium scintigraphy. Thallium images were obtained following stress both with dobutamine infusion (5-20 micrograms kg-1 min-1) and with symptom-limited bicycle ergometry in 20 patients (age 39-70 years) with chest pain who had been admitted for coronary angiography. Percentage thallium uptake was calculated using a region of interest technique. Detailed comparison was performed of the presence, size and distribution of left ventricular thallium perfusion defects; the percentage thallium uptake in ventricles, lung and liver; and the haemodynamic response to stress. Each stress produced a similar number of abnormal segments in each of three views (total EX 166/300; DOB 167/295), but exercise produced larger defects in the anterior view (P < 0.025). Thallium uptake in left and right ventricles and relative uptake to lungs were similar, but dobutamine produced higher relative liver uptake [EX 1.55 (0.67); DOB 2.97 (1.23) P < 0.0001]. Fourteen patients were able to tolerate dobutamine 20 micrograms kg-1 min-1. The ratio of peak stress to rest double product was smaller with dobutamine in both patients with (DOB 1.3; EX 2.0; P < 0.0047) and patients without beta-blockade (DOB 1.5; EX 2.4; P < 0.008). Dobutamine produced fewer conventional stress endpoints of chest pain and ST depression. In conclusion, dobutamine produces a well-tolerated incremental pharmacological stress with thallium images similar to maximal exercise, and provides a useful alternative stress in patients unable to perform adequate dynamic exercise.
Authors:
D R Wallbridge; A C Tweddel; W Martin; I Hutton
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  European journal of nuclear medicine     Volume:  20     ISSN:  0340-6997     ISO Abbreviation:  Eur J Nucl Med     Publication Date:  1993 Apr 
Date Detail:
Created Date:  1993-06-11     Completed Date:  1993-06-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7606882     Medline TA:  Eur J Nucl Med     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  319-23     Citation Subset:  IM    
Affiliation:
Department of Medical Cardiology, Royal Infirmary, Glasgow, UK.
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MeSH Terms
Descriptor/Qualifier:
Coronary Angiography
Coronary Disease / radiography,  radionuclide imaging*
Dobutamine / diagnostic use*
Electrocardiography
Exercise Test*
Exercise Tolerance
Female
Heart / radionuclide imaging*
Humans
Male
Middle Aged
Thallium Radioisotopes / diagnostic use*
Chemical
Reg. No./Substance:
0/Thallium Radioisotopes; 34368-04-2/Dobutamine

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


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