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Title: Prevalence of high risk Tl-201 scintigraphic findings in patients with coronary artery disease: Relation to coronary anatomy and ECG stress test findings

The prevalence of a high risk exercise (Ex) Tl-201 (Tl) scintigram (scint) was determined in 295 consecutive patients (pts) with angiographic (angio) (>50% stenosis) coronary artery disease (CAD) and correlated with extent of CAD and Ex stress test findings. A high risk scint by quantitative criteria was defined as either: 1) a typical left main (LM) CAD pattern showing greater than or equal to 25% homogenous disease in Tl activity in septal and posterolateral walls; 2) a multivessel disease (MVD) pattern showing abnormal Tl uptake and/or washout in multiple vascular scan segments; 3) increased lung Tl uptake. The typical LMCAD pattern was observed in 6 of 43 pts (14%) with LMCAD compared to 2% of 53 pts with 3VD (p=0.03), 3% of 99 pts with 2VD (p=0.02) and 2% of 100 pts with 1VD (p-0.01). The MVD scint pattern was seen in 67% of pts with LMCAD compared to 49% (p=0.05) in 3VD pts, 41% (p=0.004) in 2VD pts and 24% (p=<0.0001) in 1VD pts. Prevalence of abnormal lung Tl was comparable in LMCAD (42%), 3VD (38%) and 2VD (34%) pts, but greater than observed in 1VD pts (26%; p=0.05). High risk ECG stress test was defined as 2 ormore » more of: 1) >2.0 mm of ST decreasing; 2) greater than or equal to1.0 mm ST decreasing persisting >5 min post-EX; 3) ST decreasing at less than or equal to5 METS; 4) greater than or equal to10 mm Hg decreasing in Ex blood pressure. A high risk ECG stress test was observed in 58% of LMCAD pts compared to 32% of 3VD pts (p=0.009), 31% of 2VD pts (p=0.003) and 16% of 1VD pts (p<0.0001). Eighty-six % of LMCAD and 70% of 2 and 3VD pts had either a high risk Ex scint or stress test. Thus, EX Tl-201 scint appears useful in identifying high risk CAD pts.« less
Authors:
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Publication Date:
OSTI Identifier:
6932602
Report Number(s):
CONF-840619-
Journal ID: CODEN: JNMEA
Resource Type:
Conference
Resource Relation:
Journal Name: J. Nucl. Med.; (United States); Journal Volume: 25:5; Conference: 31. annual meeting of the Society of Nuclear Medicine, Los Angeles, CA, USA, 5 Jun 1984
Research Org:
Univ. of Virginia, Charlottesville, VA
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARDIOVASCULAR DISEASES; DIAGNOSIS; CORONARIES; SCINTISCANNING; HEART; THALLIUM 201; DIAGNOSTIC USES; BIOLOGICAL STRESS; BLOOD PRESSURE; ELECTROCARDIOGRAMS; EXERCISE; LUNGS; PATIENTS; RISK ASSESSMENT; TESTING; UPTAKE; ARTERIES; BETA DECAY RADIOISOTOPES; BLOOD VESSELS; BODY; CARDIOVASCULAR SYSTEM; COUNTING TECHNIQUES; DAYS LIVING RADIOISOTOPES; DIAGNOSTIC TECHNIQUES; DIAGRAMS; DISEASES; ELECTRON CAPTURE RADIOISOTOPES; HEAVY NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; NUCLEI; ODD-EVEN NUCLEI; ORGANS; RADIOISOTOPE SCANNING; RADIOISOTOPES; RESPIRATORY SYSTEM; SECONDS LIVING RADIOISOTOPES; THALLIUM ISOTOPES; USES 550601* -- Medicine-- Unsealed Radionuclides in Diagnostics