Whole-body exercise thallium imaging in smokers.
Whole-body exercise thallium imaging (WBEI) can show abnormalities of leg muscle perfusion in patients with symptomatic peripheral artery disease (PAD). This study compared the exercise distribution of thallium-201 at different levels of the legs in asymptomatic smokers and non-smokers who performed a maximal graded treadmill test. A group of 74 smokers (more than 20 pack-years) with (n = 51) or without coronary artery disease (CAD) (n = 23) were included in group 1 and 64 non-smokers with a low probability of PAD and CAD in group 2. Patients in group 1 were older than the patients in group 2 (58 +/- 9 versus 48 +/- 12 years, p < 0.0001). Indexes of asymmetry were significantly higher in group 1, at each level of the legs, both in anterior and posterior views (0.001 < p < 0.05), except at thigh level in anterior view. Fractional uptake indexes of thallium-201 were significantly lower in group 1 than in group 2 at calf level (p = 0.0001 in anterior and posterior views) and buttocks (p = 0.006 and p = 0.009 in anterior view only). Interextremity asymmetry was four to six times more frequent at calf level in smokers than in non-smokers. These WBEI abnormalities in smokers are highly suggestive of silent PAD or at least decreased vascular reactivity in clinically uninvolved vessels.
Tellier
P
P
Centre de Médecine Nucléaire de l'Artois (CMNA), Clinique Sainte Catherine, Sainte-Catherine-Les-Arras, France.
Lecouffe
P
P
Vasseur
C
C
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D005080:Exercise Test; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology; D007866:Leg / Q000098:blood supply / Q000000981:diagnostic imaging*; D008297:Male; D008833:Microcirculation / Q000000981:diagnostic imaging; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply / Q000000981:diagnostic imaging; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D011877:Radionuclide Imaging; D012907:Smoking / Q000009:adverse effects*; D013794:Thallium Radioisotopes
D013794:Thallium Radioisotopes