Thallium scintigraphy during dobutamine infusion: Nonexercise-dependent screening test for coronary disease

Mason, James R.; Palac, Robert T.; Freeman, Maynard L.; Virupannavar, S.; Loeb, Henry S.; Kaplan, Ervin; Gunnar, Rolf M.

doi:10.1016/0002-8703(84)90089-9

Cited by 136 publications

(28 citation statements)

References 23 publications

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“…6 Nuclear perfusion scans are recommended to address ventricular function in relation to vascularization and ischemia with modest specificity, while resulting in high radiation exposure. [7][8][9] Conventional coronary angiography is the gold standard for coronary artery evaluation and is able to detect CAAs, coronary artery stenosis, and thrombotic occlusion but results in risks associated with its invasive nature and the exposure to contrast and radiation. 10 A well-known problem of conventional angiography is vascular damage at the puncture site, resulting in thrombosis and occlusion of the femoral artery, which may limit the repeated use of this imaging modality in patients with KD.…”

Section: Clinical Perspective On P 720mentioning

confidence: 99%

Cardiac Magnetic Resonance Imaging for Noninvasive Assessment of Cardiovascular Disease During the Follow-Up of Patients With Kawasaki Disease

Tacke

Kuipers

Groenink

et al. 2011

Circ: Cardiovascular Imaging

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Background-Kawasaki disease (KD) is the most common cause of acquired coronary artery disease in childhood. In KD, the American Heart Association recommends echocardiography for routine coronary artery surveillance and nuclear perfusion scans and conventional coronary angiography in select patients. Cardiac MRI (CMRI) may be a noninvasive and radiation-free alternative. We applied CMRI during the follow-up of patients with KD and assessed the performance of CMRI compared with echocardiography. Methods and Results-Patients with KD aged Ն8 years were consecutively included. Sixty-three patients (median age, 14.6 years; 74.6% male sex) underwent a comprehensive CMRI protocol including adenosine stress testing to evaluate coronary artery anatomy, ischemia, and myocardial infarction. All patients underwent CMRI without significant complications. On CMRI, 23 coronary artery aneurysms (CAAs) were identified in 15 patients. CMRI detected thrombus formation in 6 CAAs in 4 patients, wall motion disturbances and ischemia in 4 patients, and delayed hyperenhancement indicating myocardial infarction in 5 patients. Wall motion and perfusion abnormalities were noted in territories supplied by affected coronary arteries. CMRI results were compared with recent echocardiography findings. In 6 of the 15 patients with CAAs on CMRI, CAAs were not detected by echocardiography. Conclusions-A comprehensive CMRI protocol including adenosine stress testing is feasible to identify coronary artery pathology, ischemia, and myocardial infarction in former patients with KD and compares favorably with echocardiography. CMRI may be used as a noninvasive and radiation-free imaging method for coronary artery surveillance during the long-term follow-up of patients with KD. (Circ Cardiovasc Imaging. 2011;4:712-720.)

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Section: Clinical Perspective On P 720mentioning

confidence: 99%

Cardiac Magnetic Resonance Imaging for Noninvasive Assessment of Cardiovascular Disease During the Follow-Up of Patients With Kawasaki Disease

Tacke

Kuipers

Groenink

et al. 2011

Circ: Cardiovascular Imaging

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“…O uso de dobutamina como agente provocador de isquemia foi publicado pela primeira vez em 1984, associado à cintilografia com tálio 2 . Nos últimos anos, o teste de estresse com dobutamina combinada à ecocardiografia tem se difundido, como método não invasivo, na avaliação de isquemia miocárdica [3][4][5][6] .…”

Section: Resultsunclassified

Sintomas, complicações e alterações hemodinâmicas associadas a ecocardiografia de estresse com dobutamina

Pinton

Lemke

Garcia

1997

Arq. Bras. Cardiol.

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Purpose -This study focuses on the safety and hemodynamic effects of dobutamine stress echocardiography.Methods -Seven hundred and thirty five consecutive patients underwent dobutamine stress echocardiography for the evaluation of coronary artery disease and or cardiomyopathy. Dobutamine was administered intravenously at incremental doses of 5, 10, 20, 30µg/kg/min, at 3min intervals Sintomas, Complicações e Alterações Hemodinâmicas Associadas a Ecocardiografia de Estresse com Dobutamina Artigo OriginalDobutamina é uma amina simpaticomimética sintética que possui propriedades adrenérgicas alfa-1, beta-1 e beta-2 1 . Com as doses terapêuticas habitualmente empregadas, os receptores beta-1 são primariamente estimulados, provocando resposta inotrópica maior do que a cronotrópica.

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“…DOB, a sympathomimetic amine, was originally proposed for use in 201 Tl stress scintigraphy by Mason et al 19 At high doses (>15 g·kg -1 ·min -1 ), DOB increases the heart rate and arterial pressure, and markedly increases myocardial contractility. These effects lead to a substantial increase in the myocardial oxygen demand, and MI is induced if coronary blood flow does not increase in proportion to the increased demand.…”

Section: Discussionmentioning

confidence: 99%

Changes in Endothelium-Derived Vascular Regulatory Factors During Dobutamine-Stress-Induced Silent Myocardial Ischemia in Patients With Kawasaki Disease

et al. 1999

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The changes in endothelium-derived vascular regulatory factors during dobutamine (DOB)-induced myocardial ischemia (MI) were investigated in 21 patients with Kawasaki disease aged from 11 months to 18 years. They were classified into an ischemia group (8 patients) and a non-ischemia group (13 patients) based on the results of 99m Tc myocardial scintigraphy and DOB stress 99m Tc myocardial scintigraphy. In the ischemia group, MI was relatively mild, because there were ischemic changes on the electrocardiogram and no significant symptoms during DOB stress. Catheters were positioned near the orifice of the coronary artery (Ao) and at the coronary sinus (CS). Hemodynamics and the blood concentrations of lactic acid and endothelin-1, as well as NO3 -, 6-ketoprostaglandin F1 , and thromboxane B2, (which are inactive metabolites of nitric oxide, prostaglandin I2 and thromboxane A2, respectively), were measured at rest and after DOB stress (maximum dose: 30 g·kg -1 ·min -1 ). The CS/Ao ratio was determined for all parameters. The rate-pressure product, an index of work load, and the cardiac index were significantly increased by DOB stress in both groups. Coronary angiography showed no vasospasm of the epicardial coronary arteries before or after DOB stress in either group. The plasma concentrations of endothelin-1 and 6-keto-prostaglandin F1 were significantly increased after DOB stress in the ischemia group, but the serum concentration of NO did not increase. The lack of an increase in NO production during DOB stress may have contributed to the worsening of MI in patients with Kawasaki disease. (Jpn Circ J 1999; 63: 503 -508)

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Thallium scintigraphy during dobutamine infusion: Nonexercise-dependent screening test for coronary disease

Cited by 136 publications

References 23 publications

Cardiac Magnetic Resonance Imaging for Noninvasive Assessment of Cardiovascular Disease During the Follow-Up of Patients With Kawasaki Disease

Cardiac Magnetic Resonance Imaging for Noninvasive Assessment of Cardiovascular Disease During the Follow-Up of Patients With Kawasaki Disease

Sintomas, complicações e alterações hemodinâmicas associadas a ecocardiografia de estresse com dobutamina

Changes in Endothelium-Derived Vascular Regulatory Factors During Dobutamine-Stress-Induced Silent Myocardial Ischemia in Patients With Kawasaki Disease

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