title: Noninvasive evaluation of myocardial ischemia in Kawasaki disease: comparison between dipyridamole stress thallium imaging and exercise stress testing.
abstract: The sensitivities of dipyridamole stress thallium 201 single photon emission computed tomography (SPECT) and treadmill exercise testing in the detection of myocardial ischemia were compared. Thirty-eight patients with Kawasaki disease and 11 age-matched controls participated in the study. Fifteen of the 38 patients with Kawasaki disease had marked coronary artery stenosis (> 75%) in at least one vessel. SPECT scans were obtained immediately after dipyridamole infusion and 4 hours later. The sensitivity of SPECT for detection of coronary stenosis was 80% (12/15), whereas that of treadmill exercise testing was only 33% (5/15) (p < 0.001). Although the sensitivity of SPECT significantly exceeded that of treadmill exercise testing among patients with coronary stenosis in only one vessel (p < 0.05), such benefits were not found for patients with stenosis in two or three vessels. These findings suggest that dipyridamole stress SPECT has a higher degree of sensitivity in the detection of myocardial ischemia than does treadmill exercise testing, especially for patients with single-vessel disease.
authors.affiliation: Department of Pediatrics, Kurume University School of Medicine, Fukuoka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Fukuda
authors.forename: T
authors.initials: T
authors.lastname: Akagi
authors.forename: M
authors.initials: M
authors.lastname: Ishibashi
authors.forename: O
authors.initials: O
authors.lastname: Inoue
authors.forename: T
authors.initials: T
authors.lastname: Sugimura
authors.forename: H
authors.initials: H
authors.lastname: Kato
mesh_terms: D002648:Child; D002675:Child, Preschool; D004176:Dipyridamole; D005080:Exercise Test; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000209:etiology; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents; D004176:Dipyridamole