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Titolo:
LEFT-VENTRICULAR LONG AXIS DISTURBANCES AS PREDICTORS FOR THALLIUM PERFUSION DEFECTS IN PATIENTS WITH KNOWN PERIPHERAL VASCULAR-DISEASE
Autore:
HENEIN MY; ANAGNOSTOPOULOS C; DAS SK; OSULLIVAN C; UNDERWOOD SR; GIBSON DG;
Indirizzi:
ROYAL BROMPTON HOSP,DEPT CARDIOL,SYDNEY ST LONDON SW3 6NP ENGLAND ROYAL BROMPTON HOSP,DEPT CARDIOL LONDON SW3 6NP ENGLAND NATL HEART & LUNG INST LONDON SW3 6NP ENGLAND ROYAL BROMPTON HOSP,DEPT NUCL MED LONDON SW3 6NP ENGLAND ROYAL BROMPTON HOSP,THROMBOSIS RES INST LONDON SW3 6NP ENGLAND
Titolo Testata:
HEART
fascicolo: 3, volume: 79, anno: 1998,
pagine: 295 - 300
SICI:
1355-6037(1998)79:3<295:LLADAP>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
ECHOCARDIOGRAPHY; SURGERY;
Keywords:
PERIPHERAL VASCULAR DISEASE; LEFT VENTRICULAR LONG AXIS; TL-201; MYOCARDIAL PERFUSION SCINTIGRAPHY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
14
Recensione:
Indirizzi per estratti:
Citazione:
M.Y. Henein et al., "LEFT-VENTRICULAR LONG AXIS DISTURBANCES AS PREDICTORS FOR THALLIUM PERFUSION DEFECTS IN PATIENTS WITH KNOWN PERIPHERAL VASCULAR-DISEASE", HEART, 79(3), 1998, pp. 295-300

Abstract

Objective-To compare resting long axis echocardiography with adenosine thallium-201 emission tomography in detecting myocardial ischaemic abnormalities in patients before peripheral vascular surgery. Design-A prospective and blinded preoperative examination of resting left ventricular minor and long axes and myocardial perfusion during adenosine vasodilatation using thallium-201 emission tomography. Setting-A tertiary referral centre for cardiac and vascular disease equipped with invasive, non-invasive, and surgical facilities. Subjects-65 patients (40 men) with significant peripheral vascular disease, mean (SD) age 63 (10) years, and 21 control subjects of similar age. Methods-Segments were classified as normal, with fixed or reversible defects according to thallium-201 myocardial perfusion tomography. Systolic long axis abnormalities were either reduced excursion and/or abnormal shortening after A2, and diastolic abnormalities either delayed onset of lengthening > 80 ms and/or reduced peak lengthening rate < 4.5 cm/s. Segmental perfusion defects were compared with the equivalent long axes; anteroseptal for septal, inferoseptal for posterior, and lateral for left side giving a total of 195 segments. Results-Systolic long axis abnormalities predicted fixed thallium defects (sensitivity 86%, specificity 87%, positive predictive value 0.78, negative predictive value 0.93, p < 0.001), and diastolic abnormalities correlated with reversible perfusiondefects (sensitivity 90%, specificity 85%, positive predictive value 0.72, negative predictive value 0.95, p < 0.001). Echocardiography characteristics of the true and false positive segments were not different in the site or the extent of abnormalities. Conclusion-Systolic longaxis abnormalities predict fixed and diastolic reversible thallium perfusion defects in patients with peripheral vascular disease. Ventricular long axis may thus have a value as a screening test before peripheral vascular surgery as well as providing a means of monitoring myocardial perfusion. The high negative predictive values indicate that a negative long axis study makes significant perfusion abnormalities very unlikely in patients with high pretest probability of coronary artery disease.

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Documento generato il 04/07/20 alle ore 13:17:37