Technetium 99m-labeled tetrofosmin myocardial tomography in patients with coronary artery disease: Comparison between adenosine and dynamic exercise stress testing

Alberto Cuocolo, Emanuele Nicolai, Andrea Soricelli, Leonardo Pace, Antonio Nappi, Pasquale Sullo, Stefania Cardei, Luigi Argenziano, Peter J. Ell, Marco Salvatore

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)194-203
Number of pages10
JournalJournal of Nuclear Cardiology
Volume3
Issue number3
DOIs
Publication statusPublished - May 1996

Keywords

  • adenosine
  • myocardial perfusion
  • technetium 99m-labeled tetrofosmin

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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