Thallium-201 myocardial perfusion imaging at rest and during exercise. Comparative sensitivity to electrocardiography in coronary artery disease
The sensitivity of myocardial perfusion imaging (MPI) using thallium-201 injected both at rest and during peak exercise was compared to simultaneously recorded 12 lead electrocardiography (ECG) for the detection of transient ischemia in 20 normal subjects and 63 patients with coronary artery disease (CAD). No significant perfusion defects or ECG changes were seen on either the rest or exercise studies in any of the normal subjects. Fifty-six percent of patients with CAD developed new perfusion defects with exercise compared to 38 percent who developed ischemic ST-segment depression (P < 0.02). However, when chest pain and/or ST depression were considered indices of ischemia, the sensitivity of exercise testing and thallium-201 MPI was similar. The increased sensitivity of MPI compared to ST-segment depression on the ECG was due to patients with baseline ECG abnormalities and those who failed to achieve 85 percent of predicted maximum heart rate with exercise. Analysis of the exercise results according to the extent of coronary artery disease revealed a progressive increase in both positive ECGs and MPI with the number of vessels involved. In patients with single vessel disease the MPI was more sensitive than the ECG (P < 0.02). The combination of the rest and exercise ECG, MPI and chest pain during exercise failed to identify 11 percent of patients with CAD. Exercise thallium-201 MPI is a useful adjunct to conventional exercise testing particularly when evaluating patients with abnormal resting ECGs, those who develop ventricular conduction defects or arrhythmias during exercise, and those who fail to achieve their predicted heart rate because of fatigue or breathlessness.
- Research Organization:
- Johns Hopkins Univ., Baltimore
- OSTI ID:
- 7310959
- Journal Information:
- Circulation; (United States), Journal Name: Circulation; (United States) Vol. 55:1; ISSN CIRCA
- Country of Publication:
- United States
- Language:
- English
Similar Records
Diagnostic value of atrial pacing and thallium-201 scintigraphy for the assessment of patients with chest pain
Atrial pacing and thallium-201 scintigraphy in patients with chest pain: correlation with coronary anatomy
Related Subjects
62 RADIOLOGY AND NUCLEAR MEDICINE
ARTERIES
BETA DECAY RADIOISOTOPES
BLOOD VESSELS
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CORONARIES
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DIAGRAMS
DISEASES
ELECTROCARDIOGRAMS
ELECTRON CAPTURE RADIOISOTOPES
EXERCISE
HEART
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MUSCLES
MYOCARDIUM
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATIENTS
PERFUSED ORGANS
RADIOISOTOPE SCANNING
RADIOISOTOPES
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
THALLIUM 201
THALLIUM ISOTOPES