Noninvasive Detection of Coronary Artery Disease by Myocardial Imaging with Thallium-201 —the significance of pharmacologic interventions—

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Abstract

We obtained myocardial imaging with T1 during pharmacologic interventions. Dipyridamoleloading myocardial imaging was performed in 38 patients with CAD. The diagnostic accuracy of this method was 66%. The combination of dipyridamoleloading and exercise stress myocardial imaging increased the diagnostic sensitivity of CAD from 71% (exercise stress imaging only) to 87%. In addition, dipyridamoleloading myocardial imaging was useful for the diagnosis of CAD in patients who could not perform exercise stress test. Chest pain and ST-segment depression were induced less often during dipyridamole administration than exercise stress test. Animal experiments showed that dipyridamole caused abnormalities in myocardial blood flow and myocardial T1 uptake distal to the critical coronary stenosis. And dipyridamole increased myocardial blood flow by 142% and myocardial T1 concentration by 62% in the normally perfused myocardial segments. Ergonovine-loading myocardial imaging was performed in 8 patients with resting angina and without significant coronary stenosis. And in all of them, ergonovine induced cold-spots on myocardial imaging with or without chest pain and ST-segment shift. Ergonovine-loading myocardial imaging was useful for the diagnosis of angina induced by coronary artery spasm. The combination of initial and delayed resting myocardial imaging was useful to differentiate the underperfused but viable myocardium from the scar. And by comparing with radionuclide angiography obtained before and after NTG administration, NTG-loading myocardial imaging and ECG findings in 20 patients with CAD, we demonstrated that the transient defective myocardial segments were underperfused but viable. © 1981, The Japanese Circulation Society. All rights reserved.

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Narita, M., Kurihara, T., & Usami, M. (1981). Noninvasive Detection of Coronary Artery Disease by Myocardial Imaging with Thallium-201 —the significance of pharmacologic interventions—. Japanese Circulation Journal, 45(1), 127–140. https://doi.org/10.1253/jcj.45.127

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