Noninvasive detection and localization of coronary stenoses in patients: comparison of resting dipyridamole and exercise /sup 201/Tl myocardial perfusion imaging

Journal Article · Tue Jun 01 04:00:00 EDT 1982 · Am. Heart J.; (United States)

DOI:https://doi.org/10.1016/0002-8703(82)90564-6· OSTI ID:6879871

Josephson, M A; Brown, B G; Hecht, H S; Hopkins, J; Pierce, C D; Petersen, R B

Two noninvasive tests to detect and localize coronary stenoses were compared in a fully blinded protocol. /sup 201/Tl myocardial perfusion imaging (MPI) following maximal treadmill exercise and pharmacologic coronary vasodilation with intravenous dipyridamole (DP) was performed in 33 patients. /sup 201/Tl imaging defects in six myocardial perfusion regions were correlated with stenoses in their respective vascular distributions. Disease severity was determined with coronary arteriograms using a computer-assisted method. 198 myocardial regions were evaluated; 101 were supplied by at least one major artery with a greater than or equal to 50% stenosis (luminal diameter narrowing). The sensitivity and specificity for detecting a greater than or equal to 50% stenosis were 85% and 64% (p less than 0.005), respectively, for DP and 84% and 68% (p less than 0.005) for exercise-/sup 201/Tl imaging. A particular combination of anterior and septal imaging defects was useful in detecting left anterior descending artery stenoses proximal to its first septal branch. DP administration was safe in this group of patients; however, 42% experienced transient chest pain. Although the overall sensitivity and specificity of the two methods were not significantly different, DP-MPI appeared more sensitive than exercise-MPI (70% vs 52%, p less than 0.01) in detecting coronary stenoses in the 40% to 60% range. DP-/sup 201/Tl MPI provides a useful alternative test for potential coronary disease patients unable to perform maximal exercise.

• Research Organization: Department of Medicine, Wadsworth Veterans Administration Hospital, Los Angeles, CA
• OSTI ID: 6879871
• Journal Information: Am. Heart J.; (United States), Journal Name: Am. Heart J.; (United States) Vol. 103:6; ISSN AHJOA
• Country of Publication: United States
• Language: English

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