Localization of coronary artery disease with exercise electrocardiography: correlation with thallium-201 myocardial perfusion scanning
In 61 patients with single vessel coronary artery disease (70 percent or greater obstruction of luminal diameter in only one vessel) and no previous myocardial infarction, the sites of ischemic changes on 12 lead exercise electrocardiography and on thallium-201 myocardial perfusion scanning were related to the obstructed coronary artery. The site of exercise-induced S-T segment depression did not identify which coronary artery was obstructed. In the 37 patients with left anterior descending coronary artery disease S-T depression was most often seen in the inferior leads and leads V4 to V6, and in the 18 patients with right coronary artery disease and in the 6 patients with left circumflex artery disease S-T depression was most often seen in leads V5 and V6. Although S-T segment elevation was uncommon in most leads, it occurred in lead V1 or a VL, or both, in 51 percent of the patients with left anterior descending coronary artery disease. A reversible anterior defect on exercise thallium scanning correlated with left anterior descending coronary artery disease (probability (p) less than 0.0001) and a reversible inferior thallium defect correlated with right coronary or left circumflex artery disease (p less than 0.0001). In patients with single vessel disease, the site of S-T segment depression does not identify the obstructed coronary artery; S-T segment elevation in lead V1 or aVL, or both, identifies left anterior descending coronary artery disease; and the site of reversible perfusion defect on thallium scanning identifies the site of myocardial ischemia and the obstructed coronary artery.
- Research Organization:
- Hallstrom Institute of Cardiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- OSTI ID:
- 5549938
- Journal Information:
- Am. J. Cardiol.; (United States), Vol. 48:5
- Country of Publication:
- United States
- Language:
- English
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59 BASIC BIOLOGICAL SCIENCES
CARDIOVASCULAR DISEASES
DIAGNOSIS
MYOCARDIUM
SCINTISCANNING
THALLIUM 201
DIAGNOSTIC USES
CORONARIES
ELECTROCARDIOGRAMS
EXERCISE
ISCHEMIA
PATHOLOGY
PATIENTS
ARTERIES
BETA DECAY RADIOISOTOPES
BLOOD VESSELS
BODY
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DIAGRAMS
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
HEART
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MUSCLES
NUCLEI
ODD-EVEN NUCLEI
ORGANS
RADIOISOTOPE SCANNING
RADIOISOTOPES
SECONDS LIVING RADIOISOTOPES
THALLIUM ISOTOPES
USES
VASCULAR DISEASES
550601* - Medicine- Unsealed Radionuclides in Diagnostics
550901 - Pathology- Tracer Techniques
551001 - Physiological Systems- Tracer Techniques