Reproducibility of equilibrium radionuclide ventriculography in patients with coronary artery disease: Response of left ventricular ejection fraction and regional wall motion to supine bicycle exercise

doi:10.1016/0002-8703(82)90228-9

American Heart Journal

Volume 104, Issue 3, September 1982, Pages 567-574

https://doi.org/10.1016/0002-8703(82)90228-9 Get rights and content

Abstract

To evaluate the reproducibility of ejection fraction (EF) and regional wall motion (RWM) analyses by rest and exercise equilibrium radionuclide ventriculography (RNV) in the presence of coronary artery disease (CAD), 18 patients underwent two maximum, multistage supine bicycle exercise studies separated by an interval of 2 weeks. There were no significant differences in EF between the two studies, both at rest (56.0 ± 13.8% vs 58.2 ± 11.7%, p = NS) and with exercise (51.1 ± 17.6% vs 54.3 ± 17.6%, p = NS) and a highly significant correlation was shown between the two groups of values (rest r = 0.90, exercise r = 0.93, p < 0.001). There was no significant difference in the change from rest to exercise (−4.9 ± 12.0% vs −3.8 ± 11.5%, p = NS) between the two studies and the correlation was highly significant (r = 0.69, p < 0.01). The interstudy variabilities were 2.2 ± 6.1% and 1.2 ± 7.3% for rest and exercise, respectively, and 2.0 ± 9.2% for the change from rest to exercise. Ninety-four percent of both rest and exercise regions had similar RWM. Eighty-one percent of the abnormally contracting regions were common to both exercise studies. Utilizing conventional criteria for the diagnosis of CAD, 11 patients had abnormal EF response and nine had abnormal RWM response to exercise on both studies. Combining EF and RWM criteria resulted in the diagnosis of CAD in 15 patients in both studies. We conclude that: (1) there were no significant differences in rest and exercise radionuclide EF and RWM between two supine bicycle exercise studies performed 2 weeks apart in patients with stable CAD and there were significant correlations between the two studies; (2) despite these correlations, the interstudy variabilities emphasize the need for the inclusion of reproducibility studies in all evaluations of interventions by exercise radionuclide ventriculography; and (3) the variations in EF and RWM response to exercise result in a lack of uniformity between the two studies regarding the diagnosis of CAD based on conventional RNV criteria.

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The recognized reliability of MUGA for assessing ventricular function was demonstrated by its selection as the method of choice for several major cardiac intervention studies in the 1980s and 1990s.38-41 The intraobserver and interobserver reproducibility of less than 3% for resting LVEF in our hands is comparable to that reported by other workers.18,19,21 Although MUGA was the tool available for sequential quantitative monitoring from the early 1980s, quantitative monitoring of LVEF is now possible with magnetic resonance imaging (MRI),42-44 which also has excellent reproducibility.
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Reproducibility of equilibrium radionuclide ventriculography in patients with coronary artery disease: Response of left ventricular ejection fraction and regional wall motion to supine bicycle exercise☆

Abstract

Am J Med

Am J Cardiol

Am J Cardiol

Am J Cardiol

Am J Cardiol

Am J Cardiol

Am J Cardiol

Am J Cardiol

Am J Cardiol

Real-time radionuclide cineangiography in the noninvasive evaluation of global and regional left ventricular function at rest and during exercise in patients with coronary heart disease

N Engl J Med

Sensitivity, specificity and predictive accuracy of radionuclide cineangiography during exercise in patients with coronary artery disease. Comparison with exercise electrocardiography

Circulation

Effects of maximal exercise stress on left ventricular function in patients with coronary artery disease using first-pass radionuclide angiocardiography. A rapid noninvasive technique for determining ejection fraction and segmental wall motion

Circulation

Detection of coronary heart disease using radionuclide determined regional ejection fraction at rest and during handgrip exercise: Correlation with coronary arteriography

Circulation

The detection of coronary artery disease with radionuclide techniques: A comparison of rest-exercise thallium imaging and ejection fraction response

Circulation

Exercise radionuclide ventriculography. Practical considerations and sensitivity of coronary artery disease detection

Radiology

Effects of coronary-artery bypass on global and regional left ventricular function during exercise

N Engl J Med