title: Quantitative severity of stress thallium-201 myocardial perfusion single-photon emission computed tomography defects in one-vessel coronary artery disease.
abstract: The relation between the quantitative myocardial perfusion defect severity of exercise thallium-201 single-photon emission computed tomography (SPECT) and the quantitative degree of coronary stenosis was examined in 18 patients with 1-vessel disease (> or = 50% diameter stenosis), and abnormal thallium-201 SPECT. A total of 26 vessels were analyzed. Thallium-201 SPECT quantitative defect severity score was derived by summing the number of pixels in a coronary territory in which counts fell below the normal mean and multiplied by the number of SDs by which they fell below the normal mean. The thallium-201 defect severity score was significantly (p < 0.001) related to the maximal percent luminal diameter narrowing (r = 0.93), percent area narrowing (r = 0.89), absolute stenotic area (r = 0.79), and absolute stenotic diameter (r = 0.81). As expected, the strongest relation between thallium-201 defect severity and quantitative angiographic indexes was in the low and high ranges of coronary stenosis, with more variability and lower correlation coefficients (percent diameter: r = 0.75, p < 0.02, percent area stenosis: r = 0.63, p < 0.05) in the middle ranges (50 to 80% diameter stenosis). This observation is likely to be due to the complex flow characteristics across stenotic lesions. The findings suggest that in a select population, thallium-201 defect severity is potentially useful for noninvasive characterization of the functional severity of coronary artery stenosis and may complement coronary angiography in predicting functionally significant stenosis.
authors.affiliation: Department of Medicine (Division of Cardiology), Cedars-Sinai Medical Center, Los Angeles, California 90048.
authors.forename: L
authors.initials: L
authors.lastname: Matzer
authors.forename: H
authors.initials: H
authors.lastname: Kiat
authors.forename: K
authors.initials: K
authors.lastname: Van Train
authors.forename: G
authors.initials: G
authors.lastname: Germano
authors.forename: M
authors.initials: M
authors.lastname: Papanicolaou
authors.forename: G
authors.initials: G
authors.lastname: Silagan
authors.forename: N
authors.initials: N
authors.lastname: Eigler
authors.forename: J
authors.initials: J
authors.lastname: Maddahi
authors.forename: D S
authors.initials: DS
authors.lastname: Berman
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography / Q000706:statistics & numerical data; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005080:Exercise Test / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012720:Severity of Illness Index; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data
chemical_list: D013794:Thallium Radioisotopes