title: Exercise testing and thallium-201 myocardial imaging in relation to coronary artery disease in patients with severe aortic valve disease.
abstract: Thirty-three patients with aortic valve disease, fifteen with regurgitation, eleven with stenosis and seven with mixed disease, undergoing assessment for valve replacement which included adequate coronary angiography, were studied. A symptom limited graded treadmill exercise test was undertaken with administration of 40-70 MBq of 201Tl. Myocardial imaging was started within 15 minutes and repeated after four hours using a 37 PM tube Searle gamma camera. Myocardial images were read independently by three observed. Of the 33 sets of images, 21 were -ve, 5 +ve, 2 I (Indeterminate) and 5 D (Difference of opinion). Eight of the 33 patients had significant coronary artery disease (CAD) and of these three were scored +ve (all triple vessel). Two patients without CAD were scored +ve. Eight subjects developed angina during exercise testing, of whom four had CAD, and four with CAD did no develop angina. Historically, 13 of the 33 subjects had typical angina, six having CAD; an additional eight had other significant chest pain, two having CAD. In these subjects with severe aortic valve disease, exercise testing and myocardial imaging with 201 TI was of little value in detecting CAD. All patients with CAD gave a history of significant chest pain.
mesh_terms: D000328:Adult; D000368:Aged; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011868:Radioisotopes; D011877:Radionuclide Imaging; D013793:Thallium
chemical_list: D011868:Radioisotopes; D013793:Thallium