TY - JOUR
T1 - Analysis of the degree of pulmonary thallium washout after exercise in patients with coronary artery disease
AU - Levy, Ronald
AU - Rozanski, Alan
AU - Berman, Daniel S.
AU - Garcia, Ernest
AU - Van Train, Ken
AU - Maddahi, Jamshid
AU - Swan, H. J.C.
N1 - Funding Information:
From the Division of Cardiology. Departments of Medicine and Nuclear Medicine, Cedars-Sinai Medical Center, and the Departments of Medicine and Radiology. UCLA School of Medicine. Los Angeles. California. This study was funded in part by National Institutes of Health SCOR Grant 17651 and a Grant-in-Aid to Dr. Rozanski from the Amencan Heart As-socration, Greater Los Angeles Affihate, Inc., Los Angeles. California. It was presented in part at the 54th Scientific Session, American Heart Association, Dallas. Texas, November 1981. Manuscript received January 17, 1983; revised manuscript received May 3, 1983. accepted May 6, 1983. *Present address: Holmes Regional Medical Center. Melbourne, Florida 32901.
PY - 1983
Y1 - 1983
N2 - An abnormal increase in pulmonary thallium activity may be visualized on post-stress thallium images in patients with coronary artery disease. Because this increased pulmonary thallium activity usually disappears by the time of redistribution imaging, this study was designed to assess whether measurement of the degree of pulmonary thallium washout between stress and redistribution might improve the detection of increased pulmonary thallium activity in patients with coronary artery disease. Quantitative analysis revealed abnormal (that is, > 2 standard deviations of normal values) pulmonary thallium washout in 59 (64%) of 92 patients with coronary artery disease, but in only 2 (25%) of 8 subjects with angiographically normal arteries (p < 0.06). By comparison, the visual analysis of pulmonary thallium washout and use of initial pulmonary to myocardial thallium ratio were significantly (p < 0.05) less sensitive in detecting abnormality in patients with coronary artery disease. Abnormal pulmonary thallium washout was related to both the anatomic extent and functional severity of disease: it occurred with greatest frequency in patients with multivessel disease and in those with exercise-induced left ventricular dysfunction (p < 0.005). When added to the quantitative analysis of myocardial scintigraphy, the analysis of pulmonary thallium washout increased the detection of coronary artery disease from 84 to 93% (p < 0.05), but the sample size was too small to assess specificity. Thus, the analysis of pulmonary thallium washout is a useful diagnostic variable because it: 1) provides an objective measurement of abnormal pulmonary thallium activity and is more sensitive than other methods; 2) correlates with both the extent of coronary artery disease and the degree of exercise-induced left ventricular dysfunction, and 3) improves the sensitivity of quantitative myocardial thallium scintigraphy to detect the presence of coronary artery disease.
AB - An abnormal increase in pulmonary thallium activity may be visualized on post-stress thallium images in patients with coronary artery disease. Because this increased pulmonary thallium activity usually disappears by the time of redistribution imaging, this study was designed to assess whether measurement of the degree of pulmonary thallium washout between stress and redistribution might improve the detection of increased pulmonary thallium activity in patients with coronary artery disease. Quantitative analysis revealed abnormal (that is, > 2 standard deviations of normal values) pulmonary thallium washout in 59 (64%) of 92 patients with coronary artery disease, but in only 2 (25%) of 8 subjects with angiographically normal arteries (p < 0.06). By comparison, the visual analysis of pulmonary thallium washout and use of initial pulmonary to myocardial thallium ratio were significantly (p < 0.05) less sensitive in detecting abnormality in patients with coronary artery disease. Abnormal pulmonary thallium washout was related to both the anatomic extent and functional severity of disease: it occurred with greatest frequency in patients with multivessel disease and in those with exercise-induced left ventricular dysfunction (p < 0.005). When added to the quantitative analysis of myocardial scintigraphy, the analysis of pulmonary thallium washout increased the detection of coronary artery disease from 84 to 93% (p < 0.05), but the sample size was too small to assess specificity. Thus, the analysis of pulmonary thallium washout is a useful diagnostic variable because it: 1) provides an objective measurement of abnormal pulmonary thallium activity and is more sensitive than other methods; 2) correlates with both the extent of coronary artery disease and the degree of exercise-induced left ventricular dysfunction, and 3) improves the sensitivity of quantitative myocardial thallium scintigraphy to detect the presence of coronary artery disease.
UR - http://www.scopus.com/inward/record.url?scp=0020593735&partnerID=8YFLogxK
U2 - 10.1016/S0735-1097(83)80312-X
DO - 10.1016/S0735-1097(83)80312-X
M3 - Article
AN - SCOPUS:0020593735
SN - 0735-1097
VL - 2
SP - 719
EP - 728
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 4
ER -