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Title: Exercise thallium-201 myocardial imaging in left main coronary artery disease: sensitive but not specific

To determine the usefulness of thallium-201 scintigraphy for identifying left main coronary artery disease, the results of scintigraphy at rest and during exercise were compared in 24 patients with 50 percent or greater narrowing of the left main coronary artery and 80 patients with 50 percent or greater narrowing of one or more of the major coronary arteries but without left main coronary involvement. By segmental analysis of the scintigrams, perfusion defects were assigned to the left anterior descending, left circumflex or right coronary artery, singly or in combination, and the pattern of simultaneous left anterior descending and circumflex arterial defects was used to identify left main coronary artery disease. Of the 24 patients with left main coronary artery disease, 22 (92 percent) had abnormal exercise scintigrams. Despite this high sensitivity, the pattern of perfusion defects was not specific; the ''left main pattern'' was found in 3 patients (13 percent) with left main coronary artery disease but also in 3 (33 percent) of 9 patients with combined left anterior descending and left circumflex arterial disease, 4 (19 percent) of 21 patients with three vessel disease and 3 (6 percent) of 50 patients with one or two vessel disease but excludingmore » the group with left anterior descending plus left circumflex arterial disease. The pattern of perfusion defects in the patients with left main coronary artery disease was determined by the location and severity of narrowings in the coronary arteries downstream from the left main arterial lesion. Concomitant lesions in other arteries were found in all patients with left main coronary disease (one vessel in 1 patient, two vessels in 7 patients and three vessels in 16). For this reason, it is unlikely that even with improvements in radiopharmaceutical agents and imaging techniques, myocardial perfusion scintigraphy will be sufficiently specific for definitive identification of left main coronary artery disease.« less
Authors:
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Publication Date:
OSTI Identifier:
5367038
Resource Type:
Journal Article
Resource Relation:
Journal Name: Am. J. Cardiol.; (United States); Journal Volume: 48:2
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; 59 BASIC BIOLOGICAL SCIENCES; MYOCARDIUM; SCINTISCANNING; THALLIUM 201; DIAGNOSTIC USES; VASCULAR DISEASES; DIAGNOSIS; CORONARIES; EVALUATION; EXERCISE; PATHOLOGY; PATIENTS; SPECIFICITY; ARTERIES; BETA DECAY RADIOISOTOPES; BLOOD VESSELS; BODY; CARDIOVASCULAR SYSTEM; COUNTING TECHNIQUES; DAYS LIVING RADIOISOTOPES; DIAGNOSTIC TECHNIQUES; DISEASES; ELECTRON CAPTURE RADIOISOTOPES; HEART; HEAVY NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; MUSCLES; NUCLEI; ODD-EVEN NUCLEI; ORGANS; RADIOISOTOPE SCANNING; RADIOISOTOPES; SECONDS LIVING RADIOISOTOPES; THALLIUM ISOTOPES; USES 550601* -- Medicine-- Unsealed Radionuclides in Diagnostics; 550901 -- Pathology-- Tracer Techniques; 551001 -- Physiological Systems-- Tracer Techniques