Assessment of stenosis severity: Correlation of angiography, T1-201 scintigraphy, and intracoronary pressure gradients
To clarify the relationship between angiographic and hemodynamic stenosis severity and the appearance during stress-redistribution myocardial T1-201 scintigraphy (Ex-T1) of a visual (V) or quantitative (Q) perfusion defect (PD) or washout (WO) abnormality, 24 pts with CAD underwent intracoronary pressure gradient study at bypass surgery (CABG). All had pre-CABG Ex-T1 without interval deterioration. The mean diastolic pressure gradient (MDG) measured at reproducible hyperemic flow rates was determined for 34 stenoses (13 LAD, 7 LCX, 14 RCA) and compared with the results of Ex-T1 in subtended myocardial regions (LAD=anterior; LCX=posterolateral; RCA=inferior). Fourteen stenoses (50-99% diameter narrowing) were unassociated with VPD despite maximal exercise: MDG was 9 +- 5mmHg, with MDG/mean aortic diastolic pressure (ADP) ratio of 0.12 +- 0.07. QPD and QWO analysis detected 8 of these. Thirteen stenoses (90-100% severity) led to reversible VPD: MDG was 36 +- 11 mm Hg, MDG/ADP ratio was 0.52 +- 0.17, and Q analysis was abnormal in 12/13. Seven stenoses (90-100% severity) subtended infarcted myocardium: MDG was 42 +- 21 mm Hg, MDG/ADP ratio was 0.52 +- 0.18, and V and Q analyses were abnormal in all. From this study, the authors derive the following conclusion: 1) Ex-T1 correlates better with hemodynamic severity of stenoses than does angiography; 2) V abnormalities identify stenoses of major angiographic and hemodynamic severity, while Q analysis detects some (57% in this study) stenoses of lesser severity; and 3) stenoses causing reversible Ex-T1 abnormalities present similar hemodynamic impediments to those causing myocardial infarcts.
- Research Organization:
- Cedars-Sinai Medical Center, Los Angeles, CA
- OSTI ID:
- 6548360
- Report Number(s):
- CONF-840619-; TRN: 87-022239
- Journal Information:
- J. Nucl. Med.; (United States), Vol. 25:5; Conference: 31. annual meeting of the Society of Nuclear Medicine, Los Angeles, CA, USA, 5 Jun 1984
- Country of Publication:
- United States
- Language:
- English
Similar Records
Usefulness and limitations of thallium-201 myocardial scintigraphy in delineating location and size of prior myocardial infarction
Cardiac imaging and myocardial kinetics of technetium-tertiary butyl-isonitrile during dipyridamole-induced hyperemia
Related Subjects
BIOMEDICAL RADIOGRAPHY
COMPARATIVE EVALUATIONS
HEART
BLOOD FLOW
DYNAMIC FUNCTION STUDIES
SCINTISCANNING
BLOOD PRESSURE
BLOOD VESSELS
CARDIOVASCULAR DISEASES
CORRELATIONS
DIAGNOSIS
EVALUATION
EXERCISE
MYOCARDIAL INFARCTION
MYOCARDIUM
PERFORMANCE
RADIOCARDIOGRAPHY
SURGERY
BODY
CARDIOGRAPHY
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DIAGNOSTIC TECHNIQUES
DISEASES
MEDICINE
MUSCLES
NUCLEAR MEDICINE
ORGANS
RADIOISOTOPE SCANNING
RADIOLOGY
550601* - Medicine- Unsealed Radionuclides in Diagnostics
550602 - Medicine- External Radiation in Diagnostics- (1980-)