Predicting the extent and location of coronary artery disease during the early postinfarction period by quantitative thallium-201 scintigraphy
The ability of quantitative thallium-201 scintigraphy to predict the extent and location of coronary artery disease before hospital discharge after acute myocardial infarction was evaluated in 52 patients. All patients underwent coronary angiography and serial thallium-201 imaging either at rest or after submaximal exercise stress. Two or three vessel disease was designated if abnormal thallium-201 uptake or washout patterns, or both, were seen in two or three vascular segments, respectively. Of 156 vessels analyzed in the 52 patients, 91 stenoses of 70 percent or greater were found by angiography. Seventy-four of these were predicted by scintigraphy. The specificity of scintigraphy for identifying vessel stenoses was 92 percent. Sensitivity for detecting and localizing stenoses supplying an infarct zone was 96 percent compared with 62 percent for stenoses supplying myocardium remote from the acute infarct. Perfusion abnormalities were more frequently seen in the distribution of vessels with severe stenoses than in those with moderate stenoses. Scintigraphy detected a greater proportion of left anterior descending and right coronary arterial stenoses than circumflex stenoses. In the 42 patients who underwent submaximal exercise testing, multivariate analysis of 23 clinical and laboratory variables identified multiple thallium-201 defects as the best predictor of multivessel disease. The predictive accuracy of exercise-induced S-T segment depression was only 45 percent compared with 88 percent for thallium-201 scintigraphy. Thallium-201 imaging at rest is reliable in assessing the extent of coronary disease in hospitalized patients who cannot undergo exercise testing because of unstable angina, uncompensated heart failure, poorly controlled arrhythmias or physical limitations.
- OSTI ID:
- 5587228
- Journal Information:
- Am. J. Cardiol.; (United States), Vol. 47:5
- Country of Publication:
- United States
- Language:
- English
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59 BASIC BIOLOGICAL SCIENCES
HEART
SCINTISCANNING
MYOCARDIAL INFARCTION
DIAGNOSIS
THALLIUM 201
DIAGNOSTIC USES
VASCULAR DISEASES
ADULTS
BIOLOGICAL LOCALIZATION
BIOMEDICAL RADIOGRAPHY
BLOOD VESSELS
COMPARATIVE EVALUATIONS
FORECASTING
IMAGES
PATIENTS
STATISTICS
AGE GROUPS
BETA DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MATHEMATICS
MEDICINE
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANS
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIOLOGY
SECONDS LIVING RADIOISOTOPES
THALLIUM ISOTOPES
USES
550601* - Medicine- Unsealed Radionuclides in Diagnostics
551001 - Physiological Systems- Tracer Techniques
550901 - Pathology- Tracer Techniques