Reversal of rest myocardial asynergy during exercise: a radionuclide scintigraphic study
While exercise-induced segmental left ventricular wall motion abnormalities are well described, the phenomenon of improvement in certain asynergic segments during exercise in some patients remains a curiosity. To assess this unexpected finding, results were analyzed in 85 patients with wall motion abnormalities at rest who underwent two view exercise radionuclide ventriculography and exercise thallium-201 myocardial perfusion imaging. Wall motion was scored with a 5 point system; normalization or increase of 2 or more points with exercise signified improvement. Forty-eight patients (56%) had no change or further deterioration of wall motion at peak exercise, 15 (18%) showed both improvement of wall motion and deterioration and 22 (26%) showed only improvement of wall motion. Wall motion improvement during exercise was found in 57 (20%) of 279 segments with asynergy at rest. Of these 57 segments improving with exercise, 45 (79%) showed mild and 12 (21%) showed severe asynergy at rest. Only seven segments (12%) were associated with pathologic Q waves. Thallium-201 perfusion was normal in 44 segments (77%) while only 6 segments (11%) had reversible and only 7 (12%) had nonreversible thallium-201 defects. In conclusion segments with abnormal wall motion at rest that show improvement with exercise appear to represent viable nonischemic segments.
- Research Organization:
- Cedars-Sinai Medical Center, Los Angeles, CA
- OSTI ID:
- 6234638
- Journal Information:
- J. Am. Coll. Cardiol.; (United States), Journal Name: J. Am. Coll. Cardiol.; (United States) Vol. 5; ISSN JACCD
- Country of Publication:
- United States
- Language:
- English
Similar Records
Use of thallium-201 redistribution scintigraphy in the preoperative differentiation of reversible and nonreversible myocardial asynergy
Relationship of regional myocardial perfusion to segmental wall motion. A physiologic basis for understanding the presence and reversibility of asynergy. [Assessment by /sup 201/Tl scintigraphy]
Related Subjects
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DYNAMIC FUNCTION STUDIES
ELECTRON CAPTURE RADIOISOTOPES
EXERCISE
HEART
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MUSCLES
MYOCARDIUM
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATIENTS
RADIOISOTOPE SCANNING
RADIOISOTOPES
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
THALLIUM 201
THALLIUM ISOTOPES