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Title: Prevalence of and variables associated with silent myocardial ischemia on exercise thallium-201 stress testing

Abstract

The prevalence of silent myocardial ischemia was prospectively assessed in a group of 103 consecutive patients (mean age 59 +/- 10 years, 79% male) undergoing symptom-limited exercise thallium-201 scintigraphy. Variables that best correlated with the occurrence of painless ischemia by quantitative scintigraphic criteria were examined. Fifty-nine patients (57%) had no angina on exercise testing. A significantly greater percent of patients with silent ischemia than of patients with angina had a recent myocardial infarction (31% versus 7%, p less than 0.01), had no prior angina (91% versus 64%, p less than 0.01), had dyspnea as an exercise test end point (56% versus 35%, p less than 0.05) and exhibited redistribution defects in the supply regions of the right and circumflex coronary arteries (50% versus 35%, p less than 0.05). The group with exercise angina had more ST depression (64% versus 41%, p less than 0.05) and more patients with four or more redistribution defects. However, there was no difference between the two groups with respect to mean total thallium-201 perfusion score, number of redistribution defects per patient, multi-vessel thallium redistribution pattern or extent of angiographic coronary artery disease. There was also no difference between the silent ischemia and angina groups withmore » respect to antianginal drug usage, prevalence of diabetes mellitus, exercise duration, peak exercise heart rate, peak work load, peak double (rate-pressure) product and percent of patients achieving greater than or equal to 85% of maximal predicted heart rate for age. Thus, in this study group, there was a rather high prevalence rate of silent ischemia (57%) by exercise thallium-201 criteria.« less

Authors:
; ;  [1]
  1. Univ. of Virginia Health Sciences Center, Charlottesville (USA)
Publication Date:
OSTI Identifier:
6648455
Resource Type:
Journal Article
Journal Name:
Journal of the American College of Cardiology; (USA)
Additional Journal Information:
Journal Volume: 16:1; Journal ID: ISSN 0735-1097
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ISCHEMIA; DIAGNOSIS; MYOCARDIUM; SCINTISCANNING; CORONARIES; ELECTROCARDIOGRAMS; EXERCISE; MAN; MYOCARDIAL INFARCTION; PATIENTS; THALLIUM 201; ANIMALS; ARTERIES; BETA DECAY RADIOISOTOPES; BLOOD VESSELS; BODY; CARDIOVASCULAR DISEASES; CARDIOVASCULAR SYSTEM; COUNTING TECHNIQUES; DAYS LIVING RADIOISOTOPES; DIAGNOSTIC TECHNIQUES; DIAGRAMS; DISEASES; ELECTRON CAPTURE RADIOISOTOPES; HEART; HEAVY NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; MAMMALS; MUSCLES; NUCLEI; ODD-EVEN NUCLEI; ORGANS; PRIMATES; RADIOISOTOPE SCANNING; RADIOISOTOPES; SECONDS LIVING RADIOISOTOPES; THALLIUM ISOTOPES; VASCULAR DISEASES; VERTEBRATES; 550601* - Medicine- Unsealed Radionuclides in Diagnostics

Citation Formats

Gasperetti, C M, Burwell, L R, and Beller, G A. Prevalence of and variables associated with silent myocardial ischemia on exercise thallium-201 stress testing. United States: N. p., 1990. Web. doi:10.1016/0735-1097(90)90467-4.
Gasperetti, C M, Burwell, L R, & Beller, G A. Prevalence of and variables associated with silent myocardial ischemia on exercise thallium-201 stress testing. United States. https://doi.org/10.1016/0735-1097(90)90467-4
Gasperetti, C M, Burwell, L R, and Beller, G A. 1990. "Prevalence of and variables associated with silent myocardial ischemia on exercise thallium-201 stress testing". United States. https://doi.org/10.1016/0735-1097(90)90467-4.
@article{osti_6648455,
title = {Prevalence of and variables associated with silent myocardial ischemia on exercise thallium-201 stress testing},
author = {Gasperetti, C M and Burwell, L R and Beller, G A},
abstractNote = {The prevalence of silent myocardial ischemia was prospectively assessed in a group of 103 consecutive patients (mean age 59 +/- 10 years, 79% male) undergoing symptom-limited exercise thallium-201 scintigraphy. Variables that best correlated with the occurrence of painless ischemia by quantitative scintigraphic criteria were examined. Fifty-nine patients (57%) had no angina on exercise testing. A significantly greater percent of patients with silent ischemia than of patients with angina had a recent myocardial infarction (31% versus 7%, p less than 0.01), had no prior angina (91% versus 64%, p less than 0.01), had dyspnea as an exercise test end point (56% versus 35%, p less than 0.05) and exhibited redistribution defects in the supply regions of the right and circumflex coronary arteries (50% versus 35%, p less than 0.05). The group with exercise angina had more ST depression (64% versus 41%, p less than 0.05) and more patients with four or more redistribution defects. However, there was no difference between the two groups with respect to mean total thallium-201 perfusion score, number of redistribution defects per patient, multi-vessel thallium redistribution pattern or extent of angiographic coronary artery disease. There was also no difference between the silent ischemia and angina groups with respect to antianginal drug usage, prevalence of diabetes mellitus, exercise duration, peak exercise heart rate, peak work load, peak double (rate-pressure) product and percent of patients achieving greater than or equal to 85% of maximal predicted heart rate for age. Thus, in this study group, there was a rather high prevalence rate of silent ischemia (57%) by exercise thallium-201 criteria.},
doi = {10.1016/0735-1097(90)90467-4},
url = {https://www.osti.gov/biblio/6648455}, journal = {Journal of the American College of Cardiology; (USA)},
issn = {0735-1097},
number = ,
volume = 16:1,
place = {United States},
year = {Sun Jul 01 00:00:00 EDT 1990},
month = {Sun Jul 01 00:00:00 EDT 1990}
}