tellurium and regadenoson

The purpose of this study was to assess the prognostic value of ultra-low dose thallium myocardial perfusion imaging. Three hundred and sixty-six patients (245 men) underwent ultra-low dose stress-redistribution imaging on CZT SPECT camera GE Discovery NM 530c. The stress test was performed by bicycle ergometry or regadenoson injection. The activity of 0.5 MBq (0.014 mCi) Tl-201 chloride per kilogram of body weight was administered. The stress images were acquired immediately and redistribution images were taken after 3 h. Patient follow-up was focused on combined end-point (death, myocardial infarction, unstable angina, revascularization and hospitalization for heart failure). Data analysis was performed from hospital database, with a mean period 23 months. Patients with revascularization within 1 month after SPECT was excluded as revascularization for diagnosis. Ischaemia on SPECT was found in 72 patients, 294 patients were without ischaemia. In patients with ischaemia there were 21 (29.2%) subjects with cardiac events, and 23 (7.9%) in patients without ischaemia (HR 4.15, 95% CI 2.30-7.51, p < 0.0001). Ultra-low dose thallium perfusion imaging using CZT camera provides very good prognostic results in assessment of myocardial ischaemia.

Topics: Aged; Cadmium; Coronary Circulation; Disease Progression; Equipment Design; Exercise Test; Female; Gamma Cameras; Humans; Male; Middle Aged; Myocardial Ischemia; Myocardial Perfusion Imaging; Pilot Projects; Predictive Value of Tests; Prognosis; Purines; Pyrazoles; Radiation Dosage; Radiation Exposure; Radiopharmaceuticals; Reproducibility of Results; Tellurium; Thallium Radioisotopes; Time Factors; Tomography, Emission-Computed, Single-Photon; Vasodilator Agents; Zinc

Transient ischemic dilation (TID) of the left ventricle (LV) has not been validated as a marker of extensive coronary artery disease (CAD) for studies using a cadmium-zinc-telluride (CZT) camera with upright imaging.. TID ratios were obtained from upright stress and rest images on a CZT camera. Separate cut-off values were determined for exercise and for regadenoson stress. The cutoffs were then applied to 28 patients with extensive CAD and 101 patients without extensive CAD.. With treadmill exercise, an upright TID ratio ≥1.16 provided a positive predictive value of 50% and a negative predictive value of 85.4% for the identification of extensive CAD. In the regadenoson group, an upright TID ratio of 1.29 provided a positive predictive value of 20% and a negative predictive value of 75.9%. Although not an independent predictor of extensive CAD in all subjects, in subjects with a normal upright LVEF, it provided a predictive value by receiver operating characteristics comparable to the SSS.. Increased upright TID measurements on a CZT camera are associated with extensive CAD. The upright TID measurements can serve in an adjunctive role to SSS, and may be most effective in patients with a normal upright exercise LVEF.

Topics: Aged; Cadmium; Cohort Studies; Coronary Angiography; Coronary Artery Disease; Diagnosis, Computer-Assisted; Dilatation; Exercise Test; Female; Heart Ventricles; Humans; Image Processing, Computer-Assisted; Ischemia; Male; Middle Aged; Myocardial Perfusion Imaging; Predictive Value of Tests; Purines; Pyrazoles; Retrospective Studies; ROC Curve; Sensitivity and Specificity; Tellurium; Tomography, Emission-Computed, Single-Photon; Zinc