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

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

Keywords

  • Left ventricular function
  • Myocardial perfusion
  • Pharmacologic stress test

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

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