TY - JOUR
T1 - Impact of limited treadmill exercise on adenosine TC-99m sestamibi single-photon emission computed tomographic myocardial perfusion imaging in coronary artery disease
AU - Jamil, Gohar
AU - Ahlberg, Alan W.
AU - Elliott, Michael D.
AU - Hendel, Robert C.
AU - Holly, Thomas
AU - McGill, Carol C.
AU - Sarkis, Marlene
AU - White, Michael P.
AU - Mather, Jeffrey F.
AU - Waters, David D.
AU - Heller, Gary V.
N1 - Funding Information:
This study was supported in part by research grants from the Research Committee at Hartford Hospital, Hartford, Connecticut; and Fujisawa, Inc., Chicago, Illinois.
Copyright:
Copyright 2007 Elsevier B.V., All rights reserved.
PY - 1999/8/15
Y1 - 1999/8/15
N2 - Limited exercise combined with dipyridamole increases myocardial perfusion defect severity compared with dipyridamole alone. The impact of limited exercise combined with adenosine on myocardial perfusion defect severity is unknown. This study compares myocardial perfusion defect severity with adenosine alone and adenosine combined with limited exercise. Thirty-two patients with coronary artery disease underwent on separate days and in randomized order technetium-99m sestamibi (25 to 30 mCi) single-photon emission computed tomographic imaging at rest, after adenosine (140 μg/kg/min x 6 minutes), and after adenosine (140 μg/kg/min x 4 minutes) during 6 minutes of modified Bruce treadmill exercise (adenosine-exercise). Radiopharmaceutical was injected at 3 and 5 minutes during adenosine and adenosine-exercise, respectively. Images were interpreted by a consensus agreement of 3 nuclear cardiologists without knowledge of patient identity, stress protocol, or clinical data using a 17-segment model and 5-point scoring system. A summed stress score (SSS), summed rest score (SRS), and summed difference (SSS-SRS) score (SDS) were calculated for each image. Peak stress heart rate and rate-pressure product were higher for adenosine- exercise than adenosine (102 ± 19 vs 81 ± 11 beats/min and 13,972 ± 4,265 vs 10,623 ± 2,131, respectively; both p < 0.001). Sensitivity for detection of ≥50% coronary stenosis was 75% and 72% for adenosine-exercise and adenosine, respectively (p = NS). There were no differences in SSS and SDS between adenosine-exercise and adenosine (8.2 ± 5.9 vs 8.1 ± 6.3 and 4.9 ± 4.1 vs 5.2 ± 4.6, respectively; both p = NS). Thus, in patients with coronary artery disease, limited treadmill exercise combined with adenosine does not increase myocardial perfusion defect severity compared with standard adenosine technetium-99m sestamibi single-photon emission computed tomographic myocardial perfusion imaging.
AB - Limited exercise combined with dipyridamole increases myocardial perfusion defect severity compared with dipyridamole alone. The impact of limited exercise combined with adenosine on myocardial perfusion defect severity is unknown. This study compares myocardial perfusion defect severity with adenosine alone and adenosine combined with limited exercise. Thirty-two patients with coronary artery disease underwent on separate days and in randomized order technetium-99m sestamibi (25 to 30 mCi) single-photon emission computed tomographic imaging at rest, after adenosine (140 μg/kg/min x 6 minutes), and after adenosine (140 μg/kg/min x 4 minutes) during 6 minutes of modified Bruce treadmill exercise (adenosine-exercise). Radiopharmaceutical was injected at 3 and 5 minutes during adenosine and adenosine-exercise, respectively. Images were interpreted by a consensus agreement of 3 nuclear cardiologists without knowledge of patient identity, stress protocol, or clinical data using a 17-segment model and 5-point scoring system. A summed stress score (SSS), summed rest score (SRS), and summed difference (SSS-SRS) score (SDS) were calculated for each image. Peak stress heart rate and rate-pressure product were higher for adenosine- exercise than adenosine (102 ± 19 vs 81 ± 11 beats/min and 13,972 ± 4,265 vs 10,623 ± 2,131, respectively; both p < 0.001). Sensitivity for detection of ≥50% coronary stenosis was 75% and 72% for adenosine-exercise and adenosine, respectively (p = NS). There were no differences in SSS and SDS between adenosine-exercise and adenosine (8.2 ± 5.9 vs 8.1 ± 6.3 and 4.9 ± 4.1 vs 5.2 ± 4.6, respectively; both p = NS). Thus, in patients with coronary artery disease, limited treadmill exercise combined with adenosine does not increase myocardial perfusion defect severity compared with standard adenosine technetium-99m sestamibi single-photon emission computed tomographic myocardial perfusion imaging.
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U2 - 10.1016/S0002-9149(99)00323-9
DO - 10.1016/S0002-9149(99)00323-9
M3 - Article
C2 - 10468076
AN - SCOPUS:0033566630
SN - 0002-9149
VL - 84
SP - 400
EP - 403
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 4
ER -