SAFETY AND DIAGNOSTIC-ACCURACY OF ADENOSINE TL-201 SCINTIGRAPHY IN PATIENTS UNABLE TO EXERCISE AND THOSE WITH LEFT-BUNDLE-BRANCH BLOCK

被引:49
作者
OKEEFE, JH [1 ]
BATEMAN, TM [1 ]
SILVESTRI, R [1 ]
BARNHART, C [1 ]
机构
[1] ST LUKES HOSP, CARDIOVASC CONSULTANTS INC, MID AMER HEART INST, KANSAS CITY, MO 64111 USA
关键词
D O I
10.1016/0002-8703(92)90268-Z
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Three hundred forty consecutive patients (mean age 69 +/- 9 years) were evaluated with adenosine tomographic thallium-201 scintigraphy for suspected coronary artery disease. Minor side effects occurred in 91% of patients. Out of 28 patients (8%) with potentially serious side effects, 28 had significant atrioventricular (AV) block (second-degree, 24 patients; third-degree, four patients; syncope occurred in two patients). Acute bronchospasm and severe refractory angina pectoris occurred in one patient each. All side effects were transient and without sequelae. One hundred twenty-one patients underwent coronary angiography within 9 days of adenosine thallium imaging. The predictive accuracies of adenosine thallium imaging for identifying and localizing ischemia to a specific coronary distribution were: left anterior descending = 88%, left circumflex = 84%, right coronary = 88%. The predictive accuracy of adenosine thallium imaging in patients with left bundle branch block was 91%, and was higher than the 71% predictive accuracy noted in 39 patients who underwent exercise thallium testing (p = 0.04). It is concluded that adenosine thallium-201 myocardial scintigraphy was (1) highly accurate for the detection and localization of significant coronary artery disease; (2) it was more accurate at detecting ischemia in patients with left bundle branch block than exercise thallium testing, and (3) subjective side effects were common and were of no diagnostic importance; transient AV block occurred occasionally.
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页码:614 / 621
页数:8
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