title: Use of oral dipyridamole SPECT thallium-201 imaging in detection of coronary artery disease.
abstract: This study examined the merits of oral dipyridamole SPECT thallium-201 imaging in detecting CAD and multivessel CAD. The 65 patients included in this study (aged 62 +/- 11 years) were not candidates for exercise testing (for the usual reasons). Coronary arteriography revealed no significant CAD in 17 patients and greater than or equal to 50% narrowing of one or more vessels in 48 patients; 12 had one-vessel and 36 had multivessel CAD (high-risk group). Thallium-201 was injected intravenously 45 minutes after an oral dose of 375 mg of dipyridamole, and SPECT imaging was performed within 10 minutes and 4 hours after injection. There were no serious side effects; only six patients (8%) had ST segment depression and 18 patients (28%) had chest pain. The heart rate increased from 74 +/- 15 beats/min at rest to 84 +/- 14 beats/min at peak effect (p = 0.001); the systolic blood pressure did not change (130 +/- 18 and 128 +/- 20 mm Hg, respectively, p = NS). The thallium images were abnormal in 6 of 17 patients (35%) with no CAD, in 7 of 12 patients with one-vessel disease (58%), and in 34 of 36 patients with multivessel CAD (94%) (p = 0.001). Twenty-one of 25 patients (84%) with a perfusion abnormality in more than one vascular territory had multivessel CAD assessed by angiography. Thus oral dipyridamole SPECT thallium-201 imaging is a safe and inexpensive method for the detection of CAD in patients who are otherwise not candidates for exercise testing.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Philadelphia Heart Institute, Presbyterian Medical Center of Philadelphia, PA 19104.
authors.forename: S G
authors.initials: SG
authors.lastname: Beer
authors.forename: J
authors.initials: J
authors.lastname: Heo
authors.forename: B
authors.initials: B
authors.lastname: Kong
authors.forename: E
authors.initials: E
authors.lastname: Lyons
authors.forename: A S
authors.initials: AS
authors.lastname: Iskandrian
mesh_terms: D000284:Administration, Oral; D000787:Angina Pectoris / Q000139:chemically induced; D003327:Coronary Disease / Q000175:diagnosis*; D004176:Dipyridamole / Q000009:adverse effects; D004562:Electrocardiography; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D013794:Thallium Radioisotopes; D004176:Dipyridamole