TY - JOUR
T1 - Comparison of exercise electrocardiography and quantitative thallium imaging for one-vessel coronary artery disease
AU - Kaul, Sanjiv
AU - Kiess, Marla
AU - Guiney, Timothy E.
AU - Pohost, Gerald M.
AU - Okada, Robert D.
AU - Boucher, Charles A.
N1 - Funding Information:
From the Cardiac Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. This study was supported in part by the Harvard lschemia SCQR (HL 26215) and USPHS &ants HL 32953 and 07416 from the National Institutes of Health, iBethesda, Maryland. Dr. Pohost’s current affiliation: Director, Division of Cardiovascular Diseases, University of Alabama Medical Center, Birmingham, Alabama. Dr. Okada is an Established Investigator of the American Heart Association. Manuscript received December 26, 1984; revised manuscript received and accepted April 1, 1985. Address for reprints: Charles A. Boucher, MD, Cardiac Unit, Massachusetts General Hospital, Boston, Massachusetts 02114.
PY - 1985/8/1
Y1 - 1985/8/1
N2 - The relative value of exercise electrocardiography and computer analyzed thallium-201 imaging was compared in 124 patients with 1-vessel coronary artery disease (CAD). Of these, 78 had left anterior descending (LAD), 32 right and 14 left circumflex (LC) CAD. In patients with no previous myocardial infarction (MI), thallium imaging was more sensitive than the electrocardiogram (78% vs 64%, p <0.01), but in patients with previous MI, sensitivity was similar. Further, thallium imaging was more sensitive only in LAD and LC disease. Redistribution was compared with ST-segment depression as a marker of ischemia. Only in patients with prior MI (76% vs 44%, p <0.01) and only in LC and right CAD did redistribution occur more often than ST depression. Thallium imaging was more accurate in localizing stenoses than the electrocardiogram (p <0.001), but did not always correctly predict coronary anatomy. Septal thallium defects were associated with LAD disease in 84%, inferior defects with right CAD in 40% and posterolateral lesion defects with LC CAD in 22%. The results indicate the overall superiority of thallium imaging in 1-vessel CAD compared with exercise electrocardiography; however, there is a wide spectrum of extent and location of perfusion defects associated with each coronary artery. Thallium imaging complements coronary angiography by demonstrating the functional impact of CAD on myocardial perfusion.
AB - The relative value of exercise electrocardiography and computer analyzed thallium-201 imaging was compared in 124 patients with 1-vessel coronary artery disease (CAD). Of these, 78 had left anterior descending (LAD), 32 right and 14 left circumflex (LC) CAD. In patients with no previous myocardial infarction (MI), thallium imaging was more sensitive than the electrocardiogram (78% vs 64%, p <0.01), but in patients with previous MI, sensitivity was similar. Further, thallium imaging was more sensitive only in LAD and LC disease. Redistribution was compared with ST-segment depression as a marker of ischemia. Only in patients with prior MI (76% vs 44%, p <0.01) and only in LC and right CAD did redistribution occur more often than ST depression. Thallium imaging was more accurate in localizing stenoses than the electrocardiogram (p <0.001), but did not always correctly predict coronary anatomy. Septal thallium defects were associated with LAD disease in 84%, inferior defects with right CAD in 40% and posterolateral lesion defects with LC CAD in 22%. The results indicate the overall superiority of thallium imaging in 1-vessel CAD compared with exercise electrocardiography; however, there is a wide spectrum of extent and location of perfusion defects associated with each coronary artery. Thallium imaging complements coronary angiography by demonstrating the functional impact of CAD on myocardial perfusion.
UR - http://www.scopus.com/inward/record.url?scp=0021810077&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0021810077&partnerID=8YFLogxK
U2 - 10.1016/0002-9149(85)90845-8
DO - 10.1016/0002-9149(85)90845-8
M3 - Article
C2 - 4025162
AN - SCOPUS:0021810077
SN - 0002-9149
VL - 56
SP - 257
EP - 261
JO - The American journal of cardiology
JF - The American journal of cardiology
IS - 4
ER -