TY - JOUR
T1 - Technetium 99m-labeled tetrofosmin myocardial tomography in patients with coronary artery disease
T2 - Comparison between adenosine and dynamic exercise stress testing
AU - Cuocolo, Alberto
AU - Nicolai, Emanuele
AU - Soricelli, Andrea
AU - Pace, Leonardo
AU - Nappi, Antonio
AU - Sullo, Pasquale
AU - Cardei, Stefania
AU - Argenziano, Luigi
AU - Ell, Peter J.
AU - Salvatore, Marco
PY - 1996/5
Y1 - 1996/5
N2 - Background: Pharmacologic coronary vasodilation with adenosine, combined with myocardial scintigraphy, is a useful test for the diagnosis of coronary artery disease (CAD) in patients unable to exercise. It has been demonstrated recently that exercise 99mTc-labeled tetrofosmin cardiac imaging can be used for the detection of CAD. However, no data are available comparing 99mTc-labeled tetrofosmin adenosine and exercise tests in the same patients. Methods and Results: The results of adenosine and exercise 99mTc-labeled tetrofosmin myocardial tomography were compared in 41 patients (37 men and four women; mean age 53±8 years) with suspected or known CAD who underwent coronary angiography. All patients were submitted, on separate days, to three injections of 99mTc-labeled tetrofosmin (740 MBq intravenously): one at rest, one during bicycle exercise, and one during adenosine infusion (140 μg/kg/min for 6 minutes with injection of 99mTc-labeled tetrofosmin at 4 minutes). A total of 902 myocardial segments were analyzed quantitatively. One patient had normal coronary vessels, 19 patients had single-vessel CAD, 12 patients had two-vessel CAD, and nine patients had three-vessel CAD (>50% coronary stenosis) on coronary angiography. Adenosine induced a significant increase in heart rate (88±16 beats/min at peak vs 72±11 beats/min at rest; p99mTc-99m-labeled tetrofosmin uptake was observed (r=0.90; p99mTc-labeled tetrofosmin uptake score between exercise and adenosine was observed in 737 (82%) of the 902 segments (kappa value of 0.66). Concordance between the two studies for identification of perfusion status was observed in 809 (90%) of the segments (kappa value of 0.80). Sensitivity and specificity for detection of stenosed vessels were not different for dynamic exercise stress testing and adenosine 99mTc-labeled tetrofosmin cardiac tomography. Conclusions: Despite different hemodynamic effects, adenosine and dynamic exercise 99mTc-labeled tetrofosmin single-photon emission computed tomographic imaging provides similar information in the diagnosis and localization of CAD.
AB - Background: Pharmacologic coronary vasodilation with adenosine, combined with myocardial scintigraphy, is a useful test for the diagnosis of coronary artery disease (CAD) in patients unable to exercise. It has been demonstrated recently that exercise 99mTc-labeled tetrofosmin cardiac imaging can be used for the detection of CAD. However, no data are available comparing 99mTc-labeled tetrofosmin adenosine and exercise tests in the same patients. Methods and Results: The results of adenosine and exercise 99mTc-labeled tetrofosmin myocardial tomography were compared in 41 patients (37 men and four women; mean age 53±8 years) with suspected or known CAD who underwent coronary angiography. All patients were submitted, on separate days, to three injections of 99mTc-labeled tetrofosmin (740 MBq intravenously): one at rest, one during bicycle exercise, and one during adenosine infusion (140 μg/kg/min for 6 minutes with injection of 99mTc-labeled tetrofosmin at 4 minutes). A total of 902 myocardial segments were analyzed quantitatively. One patient had normal coronary vessels, 19 patients had single-vessel CAD, 12 patients had two-vessel CAD, and nine patients had three-vessel CAD (>50% coronary stenosis) on coronary angiography. Adenosine induced a significant increase in heart rate (88±16 beats/min at peak vs 72±11 beats/min at rest; p99mTc-99m-labeled tetrofosmin uptake was observed (r=0.90; p99mTc-labeled tetrofosmin uptake score between exercise and adenosine was observed in 737 (82%) of the 902 segments (kappa value of 0.66). Concordance between the two studies for identification of perfusion status was observed in 809 (90%) of the segments (kappa value of 0.80). Sensitivity and specificity for detection of stenosed vessels were not different for dynamic exercise stress testing and adenosine 99mTc-labeled tetrofosmin cardiac tomography. Conclusions: Despite different hemodynamic effects, adenosine and dynamic exercise 99mTc-labeled tetrofosmin single-photon emission computed tomographic imaging provides similar information in the diagnosis and localization of CAD.
KW - adenosine
KW - myocardial perfusion
KW - technetium 99m-labeled tetrofosmin
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U2 - 10.1016/S1071-3581(96)90033-1
DO - 10.1016/S1071-3581(96)90033-1
M3 - Article
C2 - 8805739
AN - SCOPUS:15844411537
VL - 3
SP - 194
EP - 203
JO - Journal of Nuclear Cardiology
JF - Journal of Nuclear Cardiology
SN - 1071-3581
IS - 3
ER -