Radionuclide-determined change in pulmonary blood volume with exercise. Improved sensitivity of multigated blood-pool scanning in detecting coronary-artery disease.
To assess the clinical usefulness of radionuclide-determined changes in pulmonary blood volume in patients with or without substantial coronary-artery disease, we determined the ratio of pulmonary blood volume at rest as compared with that during exercise. We used multigated blood-pool images obtained at rest and during supine exercise to determine the blood-volume ratio in patients subsequently undergoing coronary arteriography for evaluation of chest pain. Exercise tests were performed by use of a submaximal-workload protocol, although all tests were limited according to each patient's symptoms. The mean exercise/rest pulmonary-blood-volume ratios were lower for persons without coronary-artery disease (0.94 +/- 0.06 [S.D.], 10 patients) and for those with disease confined to the right coronary artery (0.99 +/- 0.12, five patients), as compared with all others with coronary-artery disease (1.14 +/- 0.15, 37 patients) (P less than 0.01). A pulmonary-blood-volume ratio equal to or greater than 1.06 had a sensitivity of 79 per cent. Patients with coronary-artery disease not confined to the right coronary artery usually show an increase in pulmonary blood volume during supine exercise. No such change occurs in persons without coronary-artery disease.
D000328:Adult; D001810:Blood Volume; D002302:Cardiac Output; D003327:Coronary Disease / Q000175:diagnosis / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion; D011187:Posture; D011433:Propranolol / Q000494:pharmacology; D011652:Pulmonary Circulation; D011865:Radioisotope Dilution Technique; D012146:Rest
D011433:Propranolol