The dobutamine stress test with thallium-201 single-photon emission computed tomography and radionuclide angiography: Postinfarction study

Abstract

Mild to moderate dobutamine-induced peri-infarct ischemia is compatible with an increase in contractility, whereas severe ischemia induces worsening of wall motion.

Dobutamine-induced hypoperfusion without transient wall motion abnormalities: Less severe ischemia or less severe stress?

“…To our knowledge, this is the first study to evaluate severity of myocardial ischemia in patients with reversible perfusion defects in the preseuce or absence of simultaneous transient wall motion abnormalities during stress testing. Coma-Canella et al (17) studied patients after recent myocardial infarction hy dobutamine stress with radionuciide angiography and thallium-201 SPECT on two separate days. They concluded tha; mild to moderate ischemia on the has% of visual analysis of revers?le thallium defects is compatible with improvement o: no change of regional function, whereas severe ischemia results in worsening of function.…”

“…Assessment of the severity of &hernia by perfusion scintigraphy may have some pitfalls because the latter detects flow malperfusion as well as true ischemia. Difference in perfusion may be attenuated in patients with multivessel disease (17). Finally, some patients were receiving medications, including beta-blockers.…”

“…It has been demonstrated that hypoperfusion precedes the occurrence of wall motion abnormalities in the ischemic cascade (1516). The severity of myocardial ischemia assessed by thallium scintigraphy has been reported to determine the occurrence or absence of concomitant transient wall motion abnormalities durine a dobutamine stress test (17). If this is confirmed by other studies, a combination of reversible perfusion defects and transient wall motion abnormalities would identify patients with severe ischemia and provide additional data for the management and prognostic stratification of patients with coronary artery disease.…”

Impaired myocardial fatty acid metabolism detected by123I-BMIPP in patients with unstable angina pectoris: Comparison with perfusion imaging by99mTc-sestamibi

“…The images were interpreted by two independent observers who were unaware of the clinical history and the angiographic findings of the patients. A 5-point scoring system was used for evaluating the myocardial uptakes of the tracer 25 . 26 : 0 = normal, 1 = slightly reduced, 2 = moderately reduced, 3 == severely reduced, 4= no activity.…”