Isolated scintigraphic abnormality of diffuse slow washout of myocardial thallium-201: Clinical and prognostic implications

Conference · Wed May 01 00:00:00 EDT 1985 · J. Nucl. Med.; (United States)

OSTI ID:6795471

Bateman, T; Maddahi, J; Garcia, E; Raymond, M; Nielsen, J; Berman, D

The presence of a diffuse slow washout pattern (DSWP) of T1-201 without perfusion defects (PD) during stress-redistribution (ST-RD) imaging has been demonstrated to occur in some pts with extensive myocardial hypoperfusion that is relatively balanced in severity. Because PD analysis alone could misclassify such pts, the authors studied the clinical and prognostic implications of this unique T1 pattern. Of 3080 consecutive pts who had quantitative ST-RD T1 studies, 36 (1.2%) demonstrated DSWP (delayed clearance from anterior, posterior and inferior myocardium) without any PD. Of 19 patients with coronary angiography (angio), 15 (79%) had CAD and 22 (58%) had 3-vessel (TV) or left-main (LM) disease (D). During followup of 17 +- 12 month, 13/36pts (36%) had 15 major cardiac events: death (2), myocardial infarct (4), coronary bypass (9). In 24 pts exercising to <75% of predicted HR, specificity for CAD and extensive CAD remained high (67% and 50%), and 6/14 (43%) had cardiac events. Patients were compared as to the presence (Grp A-25 pts) or absence (Grp B-11 pts) of at least one other indicator of myocardial ischemia (chest pain, ST depression, hypotension, increased lung uptake of T1) during exercise. Angio in 25 Grp A pts revealed CAD in 14 (93%) and TVD or LMD in 10 (67%). After 16 +- 13 months, 12 of these 25 (48%) had a cardiac event. Three Grp B pts had angio (2 normal, 1 with TVD) and after 20 +- 9 months, 3 (27%) had cardiac events (2 deaths, 1 infarct). The authors conclude that DSWP with a PD is strongly associated with extensive CAD and major cardiac events, especially when accompanied by other markers of ischemia. Importantly, even when exercise is submaximal and does not result in other signs of mycocardial hypoperfusion, this pattern carries an ominous prognosis.

• Research Organization: Cedars-Sinai Medical Center, Los Angeles, CA
• OSTI ID: 6795471
• Report Number(s): CONF-850611-; TRN: 87-010645
• Journal Information: J. Nucl. Med.; (United States), Vol. 26:5; Conference: 32. annual meeting of the Society of Nuclear Medicine, Houston, TX, USA, 2 Jun 1985
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
59 BASIC BIOLOGICAL SCIENCES
CARDIOVASCULAR DISEASES
DISEASE INCIDENCE
THERAPY
HEART
RADIONUCLIDE KINETICS
SCINTISCANNING
RADIOPHARMACEUTICALS
RETENTION FUNCTIONS
UPTAKE
THALLIUM 201
BIOLOGICAL MARKERS
BIOLOGICAL STRESS
EXERCISE
ISCHEMIA
MYOCARDIAL INFARCTION
PATIENTS
TISSUE DISTRIBUTION
WASHOUT
BETA DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DISEASES
DISTRIBUTION
DRUGS
ELECTRON CAPTURE RADIOISOTOPES
FUNCTIONS
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LABELLED COMPOUNDS
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PRECIPITATION SCAVENGING
RADIOISOTOPE SCANNING
RADIOISOTOPES
SECONDS LIVING RADIOISOTOPES
SEPARATION PROCESSES
THALLIUM ISOTOPES
VASCULAR DISEASES
550601* - Medicine- Unsealed Radionuclides in Diagnostics
550901 - Pathology- Tracer Techniques