Dobutamine thallium-201 SPECT imaging for assessment of peri-infarction and remote myocardial ischemia.
This study assessed the value of dobutamine 201Tl scintigraphy for detecting significant disease of infarct-related and remote coronary arteries in myocardial infarction patients.


METHODS
Dobutamine (up to 40 micrograms/kg/min)/atropine (up to 1 mg) stress test in conjunction with stress-reinjection 200Tl SPECT was performed in 71 symptomatic patients with left ventricular dysfunction > 3 mo after myocardial infarction. Ischemia was defined as reversible perfusion defects.


RESULTS
Significant coronary artery stenosis (> or = 50% luminal diameter stenosis) was detected in all patients. Sensitivity, specificity and accuracy of regional ischemia for the diagnosis of remote coronary artery stenosis were 74% (95% Cl 63-86), 80% (Cl 70-90) and 76% (Cl 65-87), respectively. Those for infarct-related artery stenosis were 71% (Cl 60-81), 83% (Cl 75-92) and 72% (Cl 61-82), respectively. Ischemic perfusion score was higher in patients with multiversus single-vessel disease (1056 +/- 1021 versus 423 +/- 633, p < 0.01).


CONCLUSIONS
Dobutamine thallium scintigraphy is valuable for assessing the extent of coronary stenosis on the basis of reversible hypoperfusion in symptomatic patients late after myocardial infarction.
Elhendy
A
A
Thoraxcenter, University Hospital Rotterdam-Dijkzigt, The Netherlands.
Cornel
J H
JH
Roelandt
J R
JR
van Domburg
R T
RT
Geleijnse
M L
ML
Hoeymans
P A
PA
Reijs
A E
AE
TenCate
F J
FJ
Ibrahim
M M
MM
Fioretti
P M
PM
D001285:Atropine; D003326:Coronary Circulation; D003327:Coronary Disease / Q000000981:diagnostic imaging; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D004280:Dobutamine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012680:Sensitivity and Specificity; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging
D013794:Thallium Radioisotopes; D004280:Dobutamine; D001285:Atropine