Prevalence of high-risk thallium-201 scintigraphic findings in left main coronary artery stenosis: comparison with patients with multiple- and single-vessel coronary artery disease

Am J Cardiol. 1984 Feb 1;53(4):462-9. doi: 10.1016/0002-9149(84)90013-4.

Abstract

To determine the prevalence of high-risk thallium-201 (Tl-201) scintigraphic findings in patients with left main (LM) coronary artery disease (CAD), quantitative exercise Tl-201 scintigrams were analyzed in 295 consecutive patients with angiographic (greater than or equal to 50% stenosis) CAD, of which 43 (14%) had greater than or equal to 50% LM stenosis. A high-risk scintigram was defined as one that demonstrated (1) a LMCAD scintigraphic pattern (greater than or equal to 25% homogeneous decrease in Tl-201 activity in the middle and upper septal and posterolateral walls on the 45 degree left anterior oblique projection); (2) abnormal Tl-201 uptake or washout in multiple vascular scan segments indicative of multivessel disease; and (3) increased lung Tl-201 uptake on the initial anterior projection image. Of the 43 patients with LMCAD, 41 (95%) had an abnormal scintigram. Thirty-three (77%) had 1 or more high-risk scintigraphic findings, including 29 (67%) with a multivessel CAD scan pattern, of which 6 (14%) demonstrated a typical LMCAD pattern; and 18 (42%) with abnormal lung Tl-201 uptake. The prevalence of a high-risk scintigram in patients with LMCAD was significantly greater than that in 53 patients with 3-vessel disease (58%) (p = 0.05), 99 patients with 2-vessel disease (60%) (p = 0.04) and 100 patients with 1-vessel disease (41%) (p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Blood Pressure
  • Coronary Disease / diagnosis
  • Coronary Disease / diagnostic imaging*
  • Coronary Vessels / diagnostic imaging
  • Electrocardiography
  • Exercise Test
  • Female
  • Humans
  • Male
  • Middle Aged
  • Physical Exertion
  • Radioisotopes*
  • Radionuclide Imaging
  • Risk
  • Thallium*

Substances

  • Radioisotopes
  • Thallium