Submaximal exercise thallium-201 SPECT for assessment of interventional therapy in patients with acute myocardial infarction

Journal Article · Mon Apr 01 00:00:00 EST 1991 · American Heart Journal; (USA)

DOI:https://doi.org/10.1016/0002-8703(91)90660-A· OSTI ID:5802405

Stewart, R E; Kander, N; Juni, J E; Ellis, S G; O'Neill, W W; Schork, M A; Topol, E J; Schwaiger, M ^[1]

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1. Univ. of Michigan Medical Center, Ann Arbor (USA)

Submaximal thallium-201 stress testing has been shown to provide important diagnostic and prognostic information in patients with acute myocardial infarction. The purpose of this investigation was to evaluate the diagnostic value of early submaximal stress testing and thallium-201 single photon emission computed tomography (SPECT) after interventional therapy. Scintigraphic results from 56 patients with infarctions, who underwent acute thrombolytic therapy, angioplasty, or both, were compared with late (6 weeks) functional outcome as assessed by radionuclide ventriculography and with results of discharge coronary angiography. A linear correlation was found between the extent of thallium-201 SPECT perfusion defect and late ventricular function (r = 0.74, p less than 0.01). Forty-two percent of patients with large SPECT perfusion defects had normal left ventricular ejection fractions, suggesting an overestimation of infarct size by early imaging. Sensitivity and specificity of thallium-201 SPECT for detection of coronary artery stenosis in noninfarct territories was 57% and 46%, respectively, indicating limited diagnostic definition of extent of underlying coronary artery disease. Results of follow-up coronary angiography showed a significant relationship between the size of the initial perfusion defect and early restenosis or reocclusion of the infarct artery. Thus the extent of early thallium-201 perfusion defects correlates with late functional outcome but appears to overestimate the degree of injury. Submaximal thallium-201 stress testing allows only limited characterization of underlying coronary artery disease. Early assessment of infarct size may identify a patient population at high risk for reocclusion of the infarct artery.

• OSTI ID: 5802405
• Journal Information: American Heart Journal; (USA), Vol. 121:4 Pt 1, Issue 4; ISSN 0002-8703
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
HEART
IMAGE PROCESSING
MYOCARDIAL INFARCTION
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SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
SENSITIVITY ANALYSIS
BIOMEDICAL RADIOGRAPHY
COMPARATIVE EVALUATIONS
EXERCISE
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SCINTISCANNING
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ELECTRON CAPTURE RADIOISOTOPES
EMISSION COMPUTED TOMOGRAPHY
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MEDICINE
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANS
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