HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Yamagishi, H. Articles by Ochi, H. Search for Related Content PubMed PubMed Citation Articles by Yamagishi, H. Articles by Ochi, H.

Incremental Value of Left Ventricular Ejection Fraction for Detection of Multivessel Coronary Artery Disease in Exercise ²⁰¹Tl Gated Myocardial Perfusion Imaging

¹ Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Abeno-Ku, Osaka, Japan
² Department of Nuclear Medicine, Osaka City University Graduate School of Medicine, Abeno-Ku, Osaka, Japan

Assessment of reversible defects in exercise ²⁰¹Tl perfusion SPECT has low sensitivity and high specificity for detection of multivessel coronary artery disease (CAD). The goal of this study was to evaluate whether the left ventricular ejection fraction (LVEF) in exercise ²⁰¹Tl gated SPECT had incremental diagnostic value over perfusion data for detection of multivessel CAD. Methods: One hundred eighty-two patients underwent exercise ²⁰¹Tl gated SPECT. Automated LV function analysis software was used for calculation of the postexercise and the rest LVEF. The best threshold between 0- to 1-vessel CAD and 2- to 3-vessel CAD was determined as the cutoff that on receiver-operating-characteristic analysis resulted in the best sensitivity for detection of multivessel CAD with an associated specificity of >90%. Results: Only 18 (26.9%) of 67 patients with multivessel CAD had reversible defects in multiple territories. Sensitivities of the postexercise and the rest LVEF and the worsening of the LVEF by exercise did not differ from those of perfusion data alone. Sensitivities of the combination of perfusion data and the postexercise and rest LVEF did not differ from those of perfusion data alone, whereas the sensitivity of the combination of perfusion data and worsening of the LVEF (i.e., reversible defects in multiple territories or worsening of the LVEF >5.6% [or both]) was significantly greater than that of perfusion data alone (43.3% vs. 26.9%; P < 0.05), with an acceptable level of specificity (90.4%). Conclusion: The worsening of the LVEF by exercise has the potential to detect patients with multivessel CAD among those without multivessel patterns of reversible defects.

Key Words: ²⁰¹Tl • coronary artery disease • left ventricular ejection function

This article has been cited by other articles:

				S C Chua, R H Ganatra, D J Green, and A M Groves Nuclear cardiology: myocardial perfusion imaging with SPECT and PET Imaging, September 1, 2006; 18(3): 166 - 177. [Abstract] [Full Text] [PDF]

				Y. Matsumura, T. Hozumi, K. Arai, K. Sugioka, K. Ujino, Y. Takemoto, H. Yamagishi, M. Yoshiyama, and J. Yoshikawa Non-invasive assessment of myocardial ischaemia using new real-time three-dimensional dobutamine stress echocardiography: comparison with conventional two-dimensional methods Eur. Heart J., August 2, 2005; 26(16): 1625 - 1632. [Abstract] [Full Text] [PDF]

				L. Liao, W. T. Smith IV, R. H. Tuttle, L. K. Shaw, R. E. Coleman, and S. Borges-Neto Prediction of Death and Nonfatal Myocardial Infarction in High-Risk Patients: A Comparison Between the Duke Treadmill Score, Peak Exercise Radionuclide Angiography, and SPECT Perfusion Imaging J. Nucl. Med., January 1, 2005; 46(1): 5 - 11. [Abstract] [Full Text] [PDF]

				A. Manrique, A. Hitzel, D. Brasse, and P. Vera Effect of Perfusion Pattern and Imaging Sequence on Gated Perfusion SPECT Evaluation of Myocardial Stunning J. Nucl. Med., January 1, 2005; 46(1): 176 - 183. [Abstract] [Full Text] [PDF]

				T. J. Meine, M. W. Hanson, and S. Borges-Neto The Additive Value of Combined Assessment of Myocardial Perfusion and Ventricular Function Studies J. Nucl. Med., October 1, 2004; 45(10): 1721 - 1724. [Abstract] [Full Text] [PDF]

				V. Go, M. R. Bhatt, and R. C. Hendel The Diagnostic and Prognostic Value of ECG-Gated SPECT Myocardial Perfusion Imaging J. Nucl. Med., May 1, 2004; 45(5): 912 - 921. [Abstract] [Full Text] [PDF]

				G. A. Beller and D. D. Watson Risk stratification using stress myocardial perfusion imaging: don't neglect the value of clinical variables J. Am. Coll. Cardiol., January 21, 2004; 43(2): 209 - 212. [Full Text] [PDF]

				R. S. L. Lima, D. D. Watson, A. R. Goode, M. S. Siadaty, M. Ragosta, G. A. Beller, and H. Samady Incremental value of combined perfusion and function over perfusion alone by gated SPECT myocardial perfusion imaging for detection of severe three-vessel coronary artery disease J. Am. Coll. Cardiol., July 2, 2003; 42(1): 64 - 70. [Abstract] [Full Text] [PDF]