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Title: Comparison of early exercise treadmill test and oral dipyridamole thallium-201 tomography for the identification of jeopardized myocardium in patients receiving thrombolytic therapy for acute Q-wave myocardial infarction

Abstract

Thrombolytic therapy has become the treatment of choice for patients with acute myocardial infarction. Researchers are not yet able to identify patients with salvage of myocardium who are at risk for recurrent coronary events. Thus, a prospective trial was performed in 46 patients with myocardial infarction (28 anterior and 18 inferior) who received thrombolytic therapy to determine if early thallium tomography (4.7 days) using oral dipyridamole would identify more patients with residual ischemia than early symptom-limited exercise treadmill tests (5.5 days). There were no complications during the exercise treadmill tests or oral dipyridamole thallium tomography. Mean duration of exercise was 11 +/- 3 minutes and the peak heart rate was 126 beats/min. Thirteen patients had positive test results. After oral dipyridamole all patients had abnormal thallium uptake on the early images. Positive scans with partial filling in of the initial perfusion defects were evident in 34 patients. Angina developed in 13 patients and was easily reversed with intravenous aminophylline. Both symptom-limited exercise treadmill tests and thallium tomography using oral dipyridamole were safely performed early after myocardial infarction in patients receiving thrombolytic therapy. Thallium tomography identified more patients with residual ischemia than exercise treadmill tests (74 vs 28%). Further studies aremore » required to determine whether the results of thallium tomography after oral dipyridamole can be used to optimize patient management and eliminate the need for coronary angiography in some patients.« less

Authors:
; ; ; ;  [1]
  1. Univ. of North Carolina Hospitals, Chapel Hill (USA)
Publication Date:
OSTI Identifier:
6421689
Resource Type:
Journal Article
Journal Name:
American Journal of Cardiology; (USA)
Additional Journal Information:
Journal Volume: 66:5; Journal ID: ISSN 0002-9149
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARDIOVASCULAR DISEASES; DIAGNOSIS; MYOCARDIAL INFARCTION; CHEMOTHERAPY; COMPARATIVE EVALUATIONS; EXERCISE; PATIENTS; SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY; THALLIUM 201; VASODILATORS; BETA DECAY RADIOISOTOPES; CARDIOVASCULAR AGENTS; COMPUTERIZED TOMOGRAPHY; DAYS LIVING RADIOISOTOPES; DIAGNOSTIC TECHNIQUES; DISEASES; DRUGS; ELECTRON CAPTURE RADIOISOTOPES; EMISSION COMPUTED TOMOGRAPHY; HEAVY NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; NUCLEI; ODD-EVEN NUCLEI; RADIOISOTOPES; SECONDS LIVING RADIOISOTOPES; THALLIUM ISOTOPES; THERAPY; TOMOGRAPHY; 550601* - Medicine- Unsealed Radionuclides in Diagnostics

Citation Formats

Jain, A, Hicks, R R, Frantz, D M, Myers, G H, and Rowe, M W. Comparison of early exercise treadmill test and oral dipyridamole thallium-201 tomography for the identification of jeopardized myocardium in patients receiving thrombolytic therapy for acute Q-wave myocardial infarction. United States: N. p., 1990. Web. doi:10.1016/0002-9149(90)90480-O.
Jain, A, Hicks, R R, Frantz, D M, Myers, G H, & Rowe, M W. Comparison of early exercise treadmill test and oral dipyridamole thallium-201 tomography for the identification of jeopardized myocardium in patients receiving thrombolytic therapy for acute Q-wave myocardial infarction. United States. https://doi.org/10.1016/0002-9149(90)90480-O
Jain, A, Hicks, R R, Frantz, D M, Myers, G H, and Rowe, M W. 1990. "Comparison of early exercise treadmill test and oral dipyridamole thallium-201 tomography for the identification of jeopardized myocardium in patients receiving thrombolytic therapy for acute Q-wave myocardial infarction". United States. https://doi.org/10.1016/0002-9149(90)90480-O.
@article{osti_6421689,
title = {Comparison of early exercise treadmill test and oral dipyridamole thallium-201 tomography for the identification of jeopardized myocardium in patients receiving thrombolytic therapy for acute Q-wave myocardial infarction},
author = {Jain, A and Hicks, R R and Frantz, D M and Myers, G H and Rowe, M W},
abstractNote = {Thrombolytic therapy has become the treatment of choice for patients with acute myocardial infarction. Researchers are not yet able to identify patients with salvage of myocardium who are at risk for recurrent coronary events. Thus, a prospective trial was performed in 46 patients with myocardial infarction (28 anterior and 18 inferior) who received thrombolytic therapy to determine if early thallium tomography (4.7 days) using oral dipyridamole would identify more patients with residual ischemia than early symptom-limited exercise treadmill tests (5.5 days). There were no complications during the exercise treadmill tests or oral dipyridamole thallium tomography. Mean duration of exercise was 11 +/- 3 minutes and the peak heart rate was 126 beats/min. Thirteen patients had positive test results. After oral dipyridamole all patients had abnormal thallium uptake on the early images. Positive scans with partial filling in of the initial perfusion defects were evident in 34 patients. Angina developed in 13 patients and was easily reversed with intravenous aminophylline. Both symptom-limited exercise treadmill tests and thallium tomography using oral dipyridamole were safely performed early after myocardial infarction in patients receiving thrombolytic therapy. Thallium tomography identified more patients with residual ischemia than exercise treadmill tests (74 vs 28%). Further studies are required to determine whether the results of thallium tomography after oral dipyridamole can be used to optimize patient management and eliminate the need for coronary angiography in some patients.},
doi = {10.1016/0002-9149(90)90480-O},
url = {https://www.osti.gov/biblio/6421689}, journal = {American Journal of Cardiology; (USA)},
issn = {0002-9149},
number = ,
volume = 66:5,
place = {United States},
year = {Sat Sep 01 00:00:00 EDT 1990},
month = {Sat Sep 01 00:00:00 EDT 1990}
}