Assessment of left ventricular dysfunction by thallium-201 lung uptake during exercise in coronary artery disease.

Minamiji, Katsumi; Maeda, Kazumi; Nakashima, Yoshiharu; Kajiya, Teishi; Ohmori, Yoshiaki; Fukuzaki, Hisashi

doi:10.1253/jcj.47.381

Cited by 5 publications

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“…[1][2][3][4][5][6] Several clinical and experimental studies have demonstrated a correlation between lung uptake and left ventricular dysfunction, expressed as an increase in pulmonary artery wedge pressure both at rest 18,19) and after exercise. 20) Several mechanisms may be responsible for the increased T1-201 lung uptake, including augmented pulmonary transit time with consequent enhancement of extraction and increases in interstitial water or pulmonary permeability.…”

Section: Discussionmentioning

confidence: 99%

Exercise and Rest Technetium-99m-Tetrofosmin Lung Uptake

Tsou¹,

Sun²,

Kao³

et al. 2002

Jpn Heart J

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SUMMARYIncreased lung uptake of and technetium-99m (Tc-99m) MIBI in myocardial perfusion imaging is a reliable marker of left ventricular dysfunction. The goal of our study was to establish whether the lung-to-heart (L/H) uptake ratio with a newer cardiac imaging agent, Tc-99m tetrofosmin, can also provide valuable information about left ventricular function.We studied 60 patients with recent coronary artery diseases (CAD) undergoing firstpass radionuclide ventriculography to calculate left ventricular ejection fraction (LVEF) and myocardial perfusion imaging to calculate the L/H ratio. Group A consisting of 30 CAD patients with higher LVEF (≥40%) had a significanly lower L/H ratio than group B consisting of 30 CAD patients with abnormal LVEF (<40%) during exercise and rest. In groups A and B, the exercise and rest L/H ratios did not differ significantly. However, a statistically significant inverse correlation was found between the L/H ratio and LVEF during exercise and rest among the 60 patients.L/H ratios, measured by 99mTc-tetrofosmin imaging, provide clinically useful information with which to predict left ventricular dysfunction in CAD patients. (Jpn Heart J 2002; 43: 515-522)

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Section: Discussionmentioning

confidence: 99%

Exercise and Rest Technetium-99m-Tetrofosmin Lung Uptake

Tsou¹,

Sun²,

Kao³

et al. 2002

Jpn Heart J

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Thallium-201 right lung/heart ratio during exercise in patients with coronary artery disease: relation to thallium-201 myocardial single-photon emission tomography, rest and exercise left ventricular function and coronary angiography

Morel

Pézard

Furber

et al. 1999

European Journal of Nuclear Medicine and Molecular Imaging

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The aim of this study was to correlate lung thallium-201 uptake on exercise with 201Tl single-photon emission tomography (SPET) myocardial perfusion imaging, rest and exercise equilibrium radionuclide angiographic and coronary angiographic findings in patients with coronary artery disease (CAD) using a simple, reproducible lung/heart (L/H) ratio that would be easy to use in clinical practice. L/H ratio was defined on the anterior planar image obtained during exercise 201Tl SPET acquisition as the mean counts per pixel in an entire right lung field region of interest divided by the mean counts per pixel in the hottest myocardial wall region of interest. We studied 103 patients. Fifty-nine patients (group I) with <5% likelihood of CAD were used as a reference group. In 44 CAD patients (group II), L/H ratio was compared with 201Tl SPET, radionuclide angiographic and coronary angiographic variables. The group I L/H ratio of 0.35+/-0.05 (mean +/-1 SD) was significantly lower (P<0.001) than the group II L/H ratio of 0. 45+/-0.10. An L/H ratio >0.45 (mean + 2 SD in group I) was considered abnormal. In group II, L/H ratio showed a significant correlation with stress and rest 201Tl perfusion defect size (r = 0. 39 and r = 0.42, P<0.01, respectively), but not with extent of ischaemic myocardium. The mean L/H ratio was 0.41+/-0.10 in patients with one-vessel disease (n = 15), 0.46+/-0.08 in those with two-vessel disease (n = 17) and 0.47+/-0.12 in those with three-vessel disease (n = 12), but no significant difference was found between the three subgroups. L/H ratio showed a significant inverse relation with rest and exercise left ventricular ejection fraction (r = -0.37 and r = -0.50, P<0.05 and P<0.001, respectively). Using stepwise multiple regression analysis, exercise left ventricular ejection fraction and previous history of hypertension were the sole two variables independently predictive of the L/H ratio. In conclusion, although lung thallium uptake is usually found to correlate with extent and severity of CAD, increased L/H ratio should primarily be considered as a marker of exercise-induced left ventricular systolic and perhaps diastolic dysfunction, probably independent of the underlying cardiac disease.

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Lung Uptake of Technetium-99m Tetrofosmin in Healthy Subjects Is Related to Smoking Habits

Tsou¹,

Shiau

Kao³

et al. 2002

Cardiology

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To determine the influence of smoking on lung uptake of technetium-99m tetrofosmin (Tc-TF) during myocardial perfusion imaging, we examined 50 healthy subjects with normal myocardial perfusion single photon emission computed tomography findings, normal coronary angiograms, and no evidence of left ventricular hypertrophy. The 50 healthy subjects were divided into two groups. Group 1: 25 healthy subjects had smoking histories of at least 10 pack-years. Group 2: 25 healthy subjects were nonsmokers. Lung to heart ratios (L/H ratios) calculated from anterior planar images during exercise and rest states of Tc-TF myocardial perfusion imaging were obtained for all of the 50 healthy subjects. L/H ratios calculated from Tc-TF myocardial perfusion imaging in smokers were significantly higher than in nonsmokers during both exercise and rest states. However, no significant difference in L/H ratios was found between exercise and rest states in smokers and nonsmokers. In addition, a positive but nonsignificant correlation was found between smoking pack-years and either rest or exercise L/H ratios. When L/H ratios are used as a clinical diagnostic tool in Tc-TF myocardial perfusion imaging, we must consider that L/H ratios in smokers are higher than in nonsmokers.

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Assessment of left ventricular dysfunction by thallium-201 lung uptake during exercise in coronary artery disease.

Cited by 5 publications

References 0 publications

Exercise and Rest Technetium-99m-Tetrofosmin Lung Uptake

Exercise and Rest Technetium-99m-Tetrofosmin Lung Uptake

Thallium-201 right lung/heart ratio during exercise in patients with coronary artery disease: relation to thallium-201 myocardial single-photon emission tomography, rest and exercise left ventricular function and coronary angiography

Lung Uptake of Technetium-99m Tetrofosmin in Healthy Subjects Is Related to Smoking Habits

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