Dipyridamole thallium-201 imaging versus dobutamine echocardiography for the evaluation of coronary artery disease in patients unable to exercise

Christopher L. Simek, Denny D. Watson, William H. Smith, Ellen Vinson, Sanjiv Kaul

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

The present study used 51 patients in a prospective, crossover, blinded comparison of dipyridamole thallium-201 imaging and dobutamine echocardiography for (1) detection of coronary artery disease (CAD), (2) detection of inducible ischemia, and (3) determination of myocardial viability. The detection of CAD was based on quantitative defects on initial planar thallium-201 images and resting or inducible wall motion abnormalities on echocardiography. Detection of ischemia was based on redistribution on delayed thallium-201 images and inducible wall motion abnormality on echocardiography. The myocardium in a region with resting wall motion abnormality was considered viable if it showed either redistribution or >50% activity on delayed thallium-201 images, and if regional function either improved or worsened on echocardiography. The tests were comparable for the detection of CAD (53 and 59%, respectively, p = 0.23). Thallium-201 was superior to echocardiography for the detection of ischemia (35 vs 14%, respectively, p = 0.01). Although the incidence of viable myocardium was equivalent by the 2 tests (100 and 96%, respectively, p = 0.99) for each abnormally moving segment in the 24 patients with resting wall motion abnormality on echocardiography, it was greater on thallium-201 imaging (98 vs 68%, p <0.01). It is concluded that because of its better ability to detect inducible myocardial ischemia and determine viability in myocardial segments showing reduced function, dipyridamole thallium-201 imaging appears to be superior to dobutamine echocardiography for the evaluation of CAD in patients unable to exercise.

Original languageEnglish (US)
Pages (from-to)1257-1262
Number of pages6
JournalThe American Journal of Cardiology
Volume72
Issue number17
DOIs
StatePublished - Dec 1 1993
Externally publishedYes

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Dobutamine
Dipyridamole
Thallium
Echocardiography
Coronary Artery Disease
Exercise
Ischemia
Myocardium
Myocardial Ischemia
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Dipyridamole thallium-201 imaging versus dobutamine echocardiography for the evaluation of coronary artery disease in patients unable to exercise. / Simek, Christopher L.; Watson, Denny D.; Smith, William H.; Vinson, Ellen; Kaul, Sanjiv.

In: The American Journal of Cardiology, Vol. 72, No. 17, 01.12.1993, p. 1257-1262.

Research output: Contribution to journalArticle

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