Noninvasive identification of significant narrowing of the left main coronary artery by dipyridamole thallium scintigraphy

Journal Article · Thu Aug 15 00:00:00 EDT 1991 · American Journal of Cardiology; (United States)

DOI:https://doi.org/10.1016/0002-9149(91)90781-F· OSTI ID:5228811

Chikamori, T; Doi, Y L; Yonezawa, Y; Yamada, M; Seo, H; Ozawa, T ^[1]

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1. Kochi Medical School (Japan)

To evaluate the usefulness of dipyridamole thallium scintigraphy with low-level exercise for the identification of left main (LM) coronary artery disease (CAD), 466 consecutive patients with CAD were studied. Thirty-eight patients (8%) had LM stenosis (diameter narrowing greater than or equal to 50%). The LM scintigraphic pattern was present in 9 of 38 patients with LMCAD and 38 of 428 CAD patients without LMCAD (24 vs 9%; p less than 0.005). This pattern was present in 6 of 9 patients with LMCAD without right CAD and in only 3 of 29 patients with LM and right CAD (67 vs 10%; p = 0.0005). Patients with LMCAD had a higher incidence of premature cessation of low-level exercise (53 vs 21%; p less than 0.0001), chest pain (68 vs 48%; p less than 0.02), blood pressure decrease of greater than or equal to 20 mm Hg (44 vs 16%; p less than 0.002) and greater ST depression (0.17 {plus minus} 0.13 vs 0.06 {plus minus} 0.10 mV; p less than 0.001) during dipyridamole loading than patients without LMCAD. Stepwise discriminant analysis revealed that the LM scintigraphic pattern and markers of ischemia during dipyridamole loading best identified (p less than 0.0001) patients with LMCAD without right CAD (sensitivity 67%, specificity 91%), but this predictability is no better than the LM scintigraphic pattern alone. The combination of clinical markers of ischemia during dipyridamole loading and scintigraphic findings of diffuse slow washout, extensive fixed defects and the LM pattern best identified (p less than 0.0001) patients with LM and right CAD (sensitivity 72%, specificity 80%).

• OSTI ID: 5228811
• Journal Information: American Journal of Cardiology; (United States), Vol. 68:5; ISSN 0002-9149
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARDIOVASCULAR DISEASES
DIAGNOSIS
HEART
SCINTISCANNING
BLOOD PRESSURE
EXERCISE
MULTIVARIATE ANALYSIS
PATIENTS
SENSITIVITY ANALYSIS
SPECIFICITY
THALLIUM ISOTOPES
THYROXINE
VASODILATORS
AMINO ACIDS
BODY
CARBOXYLIC ACIDS
CARDIOVASCULAR AGENTS
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DIAGNOSTIC TECHNIQUES
DISEASES
DRUGS
HORMONES
ISOTOPES
MATHEMATICS
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANIC HALOGEN COMPOUNDS
ORGANIC IODINE COMPOUNDS
ORGANS
PEPTIDE HORMONES
PROTEINS
RADIOISOTOPE SCANNING
STATISTICS
THYROID HORMONES
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