Comparison of chest pain, electrocardiographic changes and thallium-201 scintigraphy during varying exercise intensities in men with stable angina pectoris

Journal Article · Sun Sep 01 04:00:00 EDT 1991 · American Journal of Cardiology; (United States)

DOI:https://doi.org/10.1016/0002-9149(91)90345-L· OSTI ID:5264892

Heller, G V; Ahmed, I; Tilkemeier, P L; Barbour, M M; Garber, C E ^[1]

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1. Memorial Hospital of Rhode Island, Pawtucket (USA)

This study was performed to evaluate the presence of angina pectoris, electrocardiographic changes and reversible thallium-201 defects resulting from 2 different levels of exercise in 19 patients with known coronary artery disease and evidence of exercise-induced ischemia. The exercise protocols consisted of a symptom-limited incremental exercise test (Bruce protocol) followed within 3 to 14 days by a submaximal, steady-state exercise test performed at 70% of the maximal heart rate achieved during the Bruce protocol. The presence and time of onset of angina and electrocardiographic changes (greater than or equal to 0.1 mV ST-segment depression) as well as oxygen uptake, exercise duration and pressure-rate product were recorded. Thallium-201 (2.5 to 3.0 mCi) was injected during the last minute of exercise during both protocols, and the images were analyzed using both computer-assisted quantitation and visual interpretations. Incremental exercise resulted in anginal symptoms in 84% of patients, and electrocardiographic changes and reversible thallium-201 defects in all patients. In contrast, submaximal exercise produced anginal symptoms in only 26% (p less than 0.01) and electrocardiographic changes in only 47% (p less than 0.05), but resulted in thallium-201 defects in 89% of patients (p = not significant). The locations of the thallium-201 defects, when present, were not different between the 2 exercise protocols. These findings confirm the sequence of the ischemic cascade using 2 levels of exercise and demonstrate that the cascade theory is applicable during varying ischemic intensities in the same patient.

• OSTI ID: 5264892
• Journal Information: American Journal of Cardiology; (United States), Journal Name: American Journal of Cardiology; (United States) Vol. 68:6; ISSN AJCDA; ISSN 0002-9149
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ANEMIAS
BETA DECAY RADIOISOTOPES
BLOOD PRESSURE
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COMPARATIVE EVALUATIONS
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGRAMS
DISEASES
ELECTROCARDIOGRAMS
ELECTRON CAPTURE RADIOISOTOPES
EVALUATION
EXERCISE
HEART
HEAVY NUCLEI
HEMIC DISEASES
IMAGE PROCESSING
ISCHEMIA
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PAIN
PATIENTS
PROCESSING
RADIOISOTOPES
SECONDS LIVING RADIOISOTOPES
SYMPTOMS
THALLIUM 201
THALLIUM ISOTOPES
VASCULAR DISEASES