[Relationship between lung-to-heart uptake ratio of technetium-99m-tetrofosmin during exercise myocardial single photon emission computed tomographic imaging and the number of diseased coronary arteries in patients with effort angina pectoris without myocardial infarction].
OBJECTIVE
Increased lung uptake of thallium-201 in exercise myocardial perfusion imaging is a reliable marker of multivessel disease in patients with ischemic heart disease. This study investigated whether the lung-to-heart uptake ratio with techenetium-99m(99mTc)-tetrofosmin also provides valuable information to detect patients with multivessel disease.


METHODS
Fifty-three consecutive patients (35 men, 18 women, mean age 66 +/- 11 years; single-vessel disease: 29, double-vessel disease: 16, triple-vessel disease: 8) with stable effort angina pectoris without prior myocardial infarction and 17 control subjects (12 men, 5 women, mean age 62 +/- 9 years) underwent exercise myocardial perfusion imaging with 99mTc-tetrofosmin and coronary angiography in January 2000 to December 2002. The lung-to-heart uptake ratio was calculated on an anterior projection before reconstruction of the exercise single photon emission computed tomographic images.


RESULTS
The mean lung-to-heart uptake ratio was 0.34 +/- 0.04, 0.38 +/- 0.07, 0.41 +/- 0.05, and 0.46 +/- 0.09, in patients with normal coronary, single-vessel disease, double-vessel disease, and triple-vessel disease, respectively. Significantly higher lung-to-heart uptake ratio was associated with more diseased vessels (p < 0.05). Multivessel disease could be detected with a sensitivity of 67% and a specificity of 74% if the cut-off point of the lung-to-heart uptake ratio was set as 0.4. Combining lung-to-heart uptake ratio with conventional myocardial perfusion imaging improved the sensitivity to detect multivessel disease to 83% and the specificity to 74%.


CONCLUSIONS
Lung-to-heart uptake ratio measured by exercise myocardial scintigraphy with 99mTc-tetrofosmin can provide clinically useful information to detect multivessel disease in patients with ischemic heart disease.
Okajima
Toshiya
T
Second Department of Internal Medicine, Memorial Heart Center, Iwate Medical University, Uchimaru 19-1, Morioka, Iwate 020-8505.
Ueshima
Kenji
K
Nishiyama
Osamu
O
Ogawa
Muneyoshi
M
Ohuchi
Mami
M
Saitoh
Masahiko
M
Hiramori
Katsuhiko
K
D000787:Angina Pectoris / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008168:Lung / Q000378:metabolism*; D008297:Male; D009203:Myocardial Infarction; D009206:Myocardium / Q000378:metabolism*; D009943:Organophosphorus Compounds / Q000378:metabolism; D015609:Organotechnetium Compounds / Q000378:metabolism; D019275:Radiopharmaceuticals / Q000378:metabolism; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon
D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C078700:technetium tc-99m tetrofosmin