Comparison of early exercise treadmill test and oral dipyridamole thallium-201 tomography for the identification of jeopardized myocardium in patients receiving thrombolytic therapy for acute Q-wave myocardial infarction

Journal Article · Sat Sep 01 00:00:00 EDT 1990 · American Journal of Cardiology; (USA)

DOI:https://doi.org/10.1016/0002-9149(90)90480-O· OSTI ID:6421689

Jain, A; Hicks, R R; Frantz, D M; Myers, G H; Rowe, M W ^[1]

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1. Univ. of North Carolina Hospitals, Chapel Hill (USA)

Thrombolytic therapy has become the treatment of choice for patients with acute myocardial infarction. Researchers are not yet able to identify patients with salvage of myocardium who are at risk for recurrent coronary events. Thus, a prospective trial was performed in 46 patients with myocardial infarction (28 anterior and 18 inferior) who received thrombolytic therapy to determine if early thallium tomography (4.7 days) using oral dipyridamole would identify more patients with residual ischemia than early symptom-limited exercise treadmill tests (5.5 days). There were no complications during the exercise treadmill tests or oral dipyridamole thallium tomography. Mean duration of exercise was 11 +/- 3 minutes and the peak heart rate was 126 beats/min. Thirteen patients had positive test results. After oral dipyridamole all patients had abnormal thallium uptake on the early images. Positive scans with partial filling in of the initial perfusion defects were evident in 34 patients. Angina developed in 13 patients and was easily reversed with intravenous aminophylline. Both symptom-limited exercise treadmill tests and thallium tomography using oral dipyridamole were safely performed early after myocardial infarction in patients receiving thrombolytic therapy. Thallium tomography identified more patients with residual ischemia than exercise treadmill tests (74 vs 28%). Further studies are required to determine whether the results of thallium tomography after oral dipyridamole can be used to optimize patient management and eliminate the need for coronary angiography in some patients.

• OSTI ID: 6421689
• Journal Information: American Journal of Cardiology; (USA), Journal Name: American Journal of Cardiology; (USA) Vol. 66:5; ISSN 0002-9149; ISSN AJCDA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
CARDIOVASCULAR AGENTS
CARDIOVASCULAR DISEASES
CHEMOTHERAPY
COMPARATIVE EVALUATIONS
COMPUTERIZED TOMOGRAPHY
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
DRUGS
ELECTRON CAPTURE RADIOISOTOPES
EMISSION COMPUTED TOMOGRAPHY
EXERCISE
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MYOCARDIAL INFARCTION
NUCLEI
ODD-EVEN NUCLEI
PATIENTS
RADIOISOTOPES
SECONDS LIVING RADIOISOTOPES
SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
THALLIUM 201
THALLIUM ISOTOPES
THERAPY
TOMOGRAPHY
VASODILATORS