Circulation, Vol 56, 66-71, Copyright © 1977 by American Heart Association
JL Ritchie, GB Trobaugh, GW Hamilton, KL Gould, KA Narahara, JA Murray and DL Williams
Myocardial imaging with intravenous thallium-201 (201Tl) was performed at
rest and following maximal treadmill exercise in 101 patients with
suspected coronary artery disease. Results were interpreted from Polaroid
scintiphotos by three independent observers with complete interobserver
agreement in 79%. Of 25 patients with no or insignificant coronary artery
disease (less than 50% diameter stenosis), one (4%) had a resting 201Tl
image defect, one (4%) had an exercise 201Tl defect, none had an ECG Q
wave, and four (16%) had exercise ST-segment depression. Among 76 patients
with coronary artery disease (greater than or equal to 50% diameter
stenosis), 58 (76%) had a defect on either the rest or exercise 201Tl
image. The proportion of patients with an exercise image defect (50/76,
66%) was greater than the proportion with exercise ST depression alone
(34/76, 45%; P less than 0.02). Overall, 69 of the 76 (91%) patients with
coronary artery disease had either a positive rest or exercise myocardial
image and/or a positive rest (ECG Q waves) or exercise (ST depression)
electrocardiogram. This exceeded the proportion with only rest or exercise
electrocardiographic abnormalities (50/76, 65%; P less than 0.001). We
conclude that rest and exercise myocardial imaging with 201Tl is easily
accomplished with readily available imaging equipment. The image data
enhanced the diagnostic sensitivity of stress electrocardiography, and
provided spatial identification of the abnormal segment(s) of myocardium.
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Myocardial imaging with thallium-201 at rest and during exercise. Comparison with coronary arteriography and resting and stress electrocardiography
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