Cold pressor thallium-201 myocardial scintigraphy in the diagnosis of coronary artery disease

Masood Ahmad, Jerzy P. Dubiel, Helmut Haibach

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Abstract

Thallium-201 myocardial scintigraphy was performed during cold pressor stimulation in 36 patients aged 37 to 69 years. Thirty-one patients had coronary artery disease and 5 patients did not, as confirmed by coronary cineangiography. Thallium-201 (1.5 to 2 mCi) was injected at 30 seconds of the cold pressor stimulation. The product of systolic pressure × heart rate increased from a baseline of 77.4 ± 16 (standard deviation [SD]) to 103.6 ± 17 at 30 seconds of the cold pressor test (p < 0.0005). Transient perfusion deficits developed in 24 of 31 patients with coronary artery disease (sensitivity 77%), and all 5 patients without coronary artery disease had normal scintigrams. The sensitivity in detecting coronary artery disease was 40% in patients with 1 vessel disease, 91% in patients with 2 vessel disease, and 100% in patients with 3 vessel disease. Exercise electrocardiograms (available in 29 of 36 patients) were positive for ischemia in 18 of 24 patients with coronary artery disease and in 1 of 5 patients without coronary artery disease (sensitivity 75% and specificity <80%). Exercise thallium-201 scintigrams, obtained in 16 patients, were positive in 11 patients with coronary artery disease and positive cold pressor thallium-201 scintigrams. Five patients without coronary artery disease and with normal cold pressor thallium-201 scintigrams had normal exercise thallium-201 scintigrams. Coronary cineangiography performed during cold pressor stimulation in 6 patients who had positive cold pressor and exercise thallium-201 scintigrams did not show coronary spasm. Our data indicate that cold pressor thallium-201 scintigraphy offers promise as a noninvasive test in the diagnosis of coronary artery disease and may be used in patients in whom exercise testing is not feasible.

Original languageEnglish (US)
Pages (from-to)1253-1257
Number of pages5
JournalThe American Journal of Cardiology
Volume50
Issue number6
DOIs
StatePublished - 1982

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Myocardial Perfusion Imaging
Thallium
Coronary Artery Disease
Exercise
Cineangiography
Spasm

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Cold pressor thallium-201 myocardial scintigraphy in the diagnosis of coronary artery disease. / Ahmad, Masood; Dubiel, Jerzy P.; Haibach, Helmut.

In: The American Journal of Cardiology, Vol. 50, No. 6, 1982, p. 1253-1257.

Research output: Contribution to journalArticle

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abstract = "Thallium-201 myocardial scintigraphy was performed during cold pressor stimulation in 36 patients aged 37 to 69 years. Thirty-one patients had coronary artery disease and 5 patients did not, as confirmed by coronary cineangiography. Thallium-201 (1.5 to 2 mCi) was injected at 30 seconds of the cold pressor stimulation. The product of systolic pressure × heart rate increased from a baseline of 77.4 ± 16 (standard deviation [SD]) to 103.6 ± 17 at 30 seconds of the cold pressor test (p < 0.0005). Transient perfusion deficits developed in 24 of 31 patients with coronary artery disease (sensitivity 77{\%}), and all 5 patients without coronary artery disease had normal scintigrams. The sensitivity in detecting coronary artery disease was 40{\%} in patients with 1 vessel disease, 91{\%} in patients with 2 vessel disease, and 100{\%} in patients with 3 vessel disease. Exercise electrocardiograms (available in 29 of 36 patients) were positive for ischemia in 18 of 24 patients with coronary artery disease and in 1 of 5 patients without coronary artery disease (sensitivity 75{\%} and specificity <80{\%}). Exercise thallium-201 scintigrams, obtained in 16 patients, were positive in 11 patients with coronary artery disease and positive cold pressor thallium-201 scintigrams. Five patients without coronary artery disease and with normal cold pressor thallium-201 scintigrams had normal exercise thallium-201 scintigrams. Coronary cineangiography performed during cold pressor stimulation in 6 patients who had positive cold pressor and exercise thallium-201 scintigrams did not show coronary spasm. Our data indicate that cold pressor thallium-201 scintigraphy offers promise as a noninvasive test in the diagnosis of coronary artery disease and may be used in patients in whom exercise testing is not feasible.",
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