Adenosine coronary vasodilation in coronary artery disease: Technetium- 99m tetrofosmin myocardial tomography versus echocardiography

A. Cuocolo, P. Sullo, L. Pace, A. Nappi, P. Gisonni, E. Nicolai, B. Trimarco, M. Salvatore

Research output: Contribution to journalArticle

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Abstract

This study compared the results of adenosine 99mTc-tetrofosmin cardiac tomography with those of adenosine echocardiography in identifying patients with coronary artery disease (CAD) and in localizing individual stenosed coronary vessels. Methods: Twenty-six consecutive patients with suspected or known CAD had simultaneous adenosine (140 μg/Kg/min intravenously) 99mTc-tetrofosmin tomography and two-dimensional echocardiography. All patients had coronary angiography within 4 wk from imaging studies. Regional 99mTc-tetrofosmin activity was quantitatively measured in 78 coronary vascular territories and echocardiographic left ventricular function was assessed in corresponding regions. Results: At coronary angiography one patient had normal coronary vessels, 12 patients one-vessel and 13 had multivessel disease (≤50% luminal stenosis). Among the 25 patients with CAD, 22 showed perfusion defects at adenosine 99mTc- tetrofosmin tomography (sensitivity 88%) and 17 had abnormal echocardiographic study (sensitivity 68%, p <0.05 versus 99mTc- tetrofosmin). Agreement for the identification of patients with CAD between adenosine 99mTc-tetrofosmin tomography and echocardiography was observed in 21 (81%) of the total 26 patients, with a kappa value of 0.45. Overall sensitivity, specificity and diagnostic accuracy for detection of individual stenosed vessels were 79%, 88% and 83% for 99mTC tetrofosmin and 57%, 68% and 61% (all p <0.05 versus 99mTc-tetrofosmin) for echocardiography. Concordance between adenosine 99mTc-tetrofosmin tomography and echocardiography in the detection of individual stenosed coronary vessels was observed in 57 (73%) of the 78 vascular territories, with a kappa value of 0.36. Conclusion: Adenosine-induced coronary vasodilation associated with quantitative 99mTc-tetrofosmin tomography is more accurate than adenosine echocardiography in identifying patients with CAD and in detecting individual stenosed coronary vessels.

Original languageEnglish
Pages (from-to)1089-1094
Number of pages6
JournalJournal of Nuclear Medicine
Volume38
Issue number7
Publication statusPublished - 1997

Fingerprint

Vasodilation
Adenosine
Echocardiography
Coronary Artery Disease
Tomography
Coronary Vessels
Coronary Angiography
Blood Vessels
technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane
Left Ventricular Function
Pathologic Constriction
Perfusion
Sensitivity and Specificity

Keywords

  • Left ventricular function
  • Myocardial perfusion
  • Pharmacologic stress test

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Adenosine coronary vasodilation in coronary artery disease : Technetium- 99m tetrofosmin myocardial tomography versus echocardiography. / Cuocolo, A.; Sullo, P.; Pace, L.; Nappi, A.; Gisonni, P.; Nicolai, E.; Trimarco, B.; Salvatore, M.

In: Journal of Nuclear Medicine, Vol. 38, No. 7, 1997, p. 1089-1094.

Research output: Contribution to journalArticle

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abstract = "This study compared the results of adenosine 99mTc-tetrofosmin cardiac tomography with those of adenosine echocardiography in identifying patients with coronary artery disease (CAD) and in localizing individual stenosed coronary vessels. Methods: Twenty-six consecutive patients with suspected or known CAD had simultaneous adenosine (140 μg/Kg/min intravenously) 99mTc-tetrofosmin tomography and two-dimensional echocardiography. All patients had coronary angiography within 4 wk from imaging studies. Regional 99mTc-tetrofosmin activity was quantitatively measured in 78 coronary vascular territories and echocardiographic left ventricular function was assessed in corresponding regions. Results: At coronary angiography one patient had normal coronary vessels, 12 patients one-vessel and 13 had multivessel disease (≤50{\%} luminal stenosis). Among the 25 patients with CAD, 22 showed perfusion defects at adenosine 99mTc- tetrofosmin tomography (sensitivity 88{\%}) and 17 had abnormal echocardiographic study (sensitivity 68{\%}, p <0.05 versus 99mTc- tetrofosmin). Agreement for the identification of patients with CAD between adenosine 99mTc-tetrofosmin tomography and echocardiography was observed in 21 (81{\%}) of the total 26 patients, with a kappa value of 0.45. Overall sensitivity, specificity and diagnostic accuracy for detection of individual stenosed vessels were 79{\%}, 88{\%} and 83{\%} for 99mTC tetrofosmin and 57{\%}, 68{\%} and 61{\%} (all p <0.05 versus 99mTc-tetrofosmin) for echocardiography. Concordance between adenosine 99mTc-tetrofosmin tomography and echocardiography in the detection of individual stenosed coronary vessels was observed in 57 (73{\%}) of the 78 vascular territories, with a kappa value of 0.36. Conclusion: Adenosine-induced coronary vasodilation associated with quantitative 99mTc-tetrofosmin tomography is more accurate than adenosine echocardiography in identifying patients with CAD and in detecting individual stenosed coronary vessels.",
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AU - Sullo, P.

AU - Pace, L.

AU - Nappi, A.

AU - Gisonni, P.

AU - Nicolai, E.

AU - Trimarco, B.

AU - Salvatore, M.

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N2 - This study compared the results of adenosine 99mTc-tetrofosmin cardiac tomography with those of adenosine echocardiography in identifying patients with coronary artery disease (CAD) and in localizing individual stenosed coronary vessels. Methods: Twenty-six consecutive patients with suspected or known CAD had simultaneous adenosine (140 μg/Kg/min intravenously) 99mTc-tetrofosmin tomography and two-dimensional echocardiography. All patients had coronary angiography within 4 wk from imaging studies. Regional 99mTc-tetrofosmin activity was quantitatively measured in 78 coronary vascular territories and echocardiographic left ventricular function was assessed in corresponding regions. Results: At coronary angiography one patient had normal coronary vessels, 12 patients one-vessel and 13 had multivessel disease (≤50% luminal stenosis). Among the 25 patients with CAD, 22 showed perfusion defects at adenosine 99mTc- tetrofosmin tomography (sensitivity 88%) and 17 had abnormal echocardiographic study (sensitivity 68%, p <0.05 versus 99mTc- tetrofosmin). Agreement for the identification of patients with CAD between adenosine 99mTc-tetrofosmin tomography and echocardiography was observed in 21 (81%) of the total 26 patients, with a kappa value of 0.45. Overall sensitivity, specificity and diagnostic accuracy for detection of individual stenosed vessels were 79%, 88% and 83% for 99mTC tetrofosmin and 57%, 68% and 61% (all p <0.05 versus 99mTc-tetrofosmin) for echocardiography. Concordance between adenosine 99mTc-tetrofosmin tomography and echocardiography in the detection of individual stenosed coronary vessels was observed in 57 (73%) of the 78 vascular territories, with a kappa value of 0.36. Conclusion: Adenosine-induced coronary vasodilation associated with quantitative 99mTc-tetrofosmin tomography is more accurate than adenosine echocardiography in identifying patients with CAD and in detecting individual stenosed coronary vessels.

AB - This study compared the results of adenosine 99mTc-tetrofosmin cardiac tomography with those of adenosine echocardiography in identifying patients with coronary artery disease (CAD) and in localizing individual stenosed coronary vessels. Methods: Twenty-six consecutive patients with suspected or known CAD had simultaneous adenosine (140 μg/Kg/min intravenously) 99mTc-tetrofosmin tomography and two-dimensional echocardiography. All patients had coronary angiography within 4 wk from imaging studies. Regional 99mTc-tetrofosmin activity was quantitatively measured in 78 coronary vascular territories and echocardiographic left ventricular function was assessed in corresponding regions. Results: At coronary angiography one patient had normal coronary vessels, 12 patients one-vessel and 13 had multivessel disease (≤50% luminal stenosis). Among the 25 patients with CAD, 22 showed perfusion defects at adenosine 99mTc- tetrofosmin tomography (sensitivity 88%) and 17 had abnormal echocardiographic study (sensitivity 68%, p <0.05 versus 99mTc- tetrofosmin). Agreement for the identification of patients with CAD between adenosine 99mTc-tetrofosmin tomography and echocardiography was observed in 21 (81%) of the total 26 patients, with a kappa value of 0.45. Overall sensitivity, specificity and diagnostic accuracy for detection of individual stenosed vessels were 79%, 88% and 83% for 99mTC tetrofosmin and 57%, 68% and 61% (all p <0.05 versus 99mTc-tetrofosmin) for echocardiography. Concordance between adenosine 99mTc-tetrofosmin tomography and echocardiography in the detection of individual stenosed coronary vessels was observed in 57 (73%) of the 78 vascular territories, with a kappa value of 0.36. Conclusion: Adenosine-induced coronary vasodilation associated with quantitative 99mTc-tetrofosmin tomography is more accurate than adenosine echocardiography in identifying patients with CAD and in detecting individual stenosed coronary vessels.

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KW - Myocardial perfusion

KW - Pharmacologic stress test

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