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Titolo:
COMPARISON BETWEEN TL-201 AND TC-99M SESTAMIBI UPTAKE DURING ADENOSINE-INDUCED VASODILATION AS A FUNCTION OF CORONARY STENOSIS SEVERITY
Autore:
GLOVER DK; RUIZ M; EDWARDS NC; CUNNINGHAM M; SIMANIS JP; SMITH WH; WATSON DD; BELLER GA;
Indirizzi:
UNIV VIRGINIA,HLTH SCI CTR,DEPT MED,DIV CARDIOL,EXPTL CARDIOL LAB,BOX158 CHARLOTTESVILLE VA 22908
Titolo Testata:
Circulation
fascicolo: 3, volume: 91, anno: 1995,
pagine: 813 - 820
SICI:
0009-7322(1995)91:3<813:CBTATS>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
EMISSION COMPUTED-TOMOGRAPHY; HEXAKIS 2-METHOXYISOBUTYL ISONITRILE; METHOXY ISOBUTYL ISONITRILE; ARTERY DISEASE; METHOXYISOBUTYL ISONITRILE; MYOCARDIAL KINETICS; CANINE MYOCARDIUM; BLOOD-FLOW; DIPYRIDAMOLE; PERFUSION;
Keywords:
VASODILATION; ISCHEMIA; ISONITRILE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
31
Recensione:
Indirizzi per estratti:
Citazione:
D.K. Glover et al., "COMPARISON BETWEEN TL-201 AND TC-99M SESTAMIBI UPTAKE DURING ADENOSINE-INDUCED VASODILATION AS A FUNCTION OF CORONARY STENOSIS SEVERITY", Circulation, 91(3), 1995, pp. 813-820

Abstract

Background Myocardial uptake of either Tl-201 or Tc-99m sestamibi (sestamibi) is known to plateau at high coronary flow rates. However, fewdirect comparisons have been made between these tracers to determine what effect differences in the uptake plateau for the two tracers may have on the detection of coronary stenoses of various severities. Methods and Results Twenty-two dogs were instrumented with flow transducers on the left anterior descending (LAD) and circumflex (LCx) arteries. In 6 nonstenotic dogs, adenosine was infused directly into the LAD, whereas 16 dogs with either critical (n=7) or mild (n=9) LAD stenoses received an intravenous infusion. At peak flow, Tl-201 (0.5 mCi), sestamibi (5 to 8 mCi), and radiolabeled microspheres were injected simultaneously. Five minutes later, dogs were killed, and ex vivo imaging of heart slices and gamma-well counting of multiple myocardial samples was performed. Neither Tl-201 nor sestamibi uptake increased in direct proportion to flow. In the 6 nonste notic dogs, a fivefold increase in LAD flow increased Tl-201 and sestamibi uptake by only 202+/-6% and 138+/-4%, respectively (P<.0001). In the dogs with critical stenosis, the ratios of stenotic to normal activity by well counting for Tl-201 (0.37+/-0.05) and sestamibi (0.53+/-0.06) underestimated the microsphere-determined flow disparity (0.17+/-0.03) (P<.005), but the degree of underestimation was greater for sestamibi (P=.001). Similarly, in the dogs with mild stenosis, the stenotic-to-normal ratio for Tl-201 (0.62+/-0.04) approximated the flow ratio (0.43+/-0.04) better than sestamibi (0.79+/-0.03) (P<.0001). Sestamibi defects, however, were visually identifiable on the images of the myocardial slices. By image quantification, sestamibi defect magnitude (LAD-to-LCx count ratio) in the critical stenosis group (0.62+/-0.05) was significantly less than in the mild stenosis group (0.80+/-0.02) (P<.01). Conclusions Thus, with adenosine-induced hyperemic flow, both Tl-201 and sestamibi significantly underestimated the magnitude of the flow disparity between stenotic andnormal perfusion beds. The degree of underestimation was greater for sestamibi. The clinical implication of these experimental findings forvasodilator perfusion imaging remains to be determined, since factorssuch as greater redistribution and scatter with Tl-201 could offset its advantages.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/11/20 alle ore 22:12:26