Comparison of exercise electrocardiography and quantitative thallium imaging for one-vessel coronary artery disease.
Comparison of exercise electrocardiography and quantitative thallium imaging for one-vessel coronary artery disease.
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单支冠状动脉疾病运动心电图和定量铊成像的比较。
DOI：
10.1016/0002-9149(85)90845-8
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发表时间：
1985
期刊：
影响因子：
--
通讯作者：
Boucher,CA
中科院分区：
文献类型：
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作者：
Kaul,S;Kiess,M;Liu,P;Guiney,TE;Pohost,GM;Okada,RD;Boucher,CA
本文比较了124例单支冠状动脉病变（CAD）患者运动心电图与计算机分析~（201）铊显像的相对价值。其中78例为左前降支（LAD），32例为右冠状动脉，14例为左回旋支（LC）。在既往无心肌梗死（MI）的患者中，铊显像比心电图更敏感（78% vs 64%，p <0.01），但在既往有MI的患者中，敏感性相似。此外，铊显像仅在LAD和LC疾病中更敏感。再分布与ST段压低作为缺血的标志进行了比较。仅在有MI病史的患者中（76% vs 44%，p <0.01），且仅在LC和右侧CAD中，再分布发生率高于ST段压低。铊成像在狭窄定位方面比心电图更准确（p <0.001），但并不总是正确预测冠状动脉解剖结构。84%的间隔铊缺损与LAD疾病相关，40%的下壁缺损与右侧CAD相关，22%的后外侧病变缺损与LC CAD相关。结果表明，与运动心电图相比，铊成像在单支冠状动脉疾病中具有整体优势;然而，与每支冠状动脉相关的灌注缺损的范围和位置范围很广。铊成像通过证明CAD对心肌灌注的功能影响来补充冠状动脉造影。
The relative value of exercise electrocardiography and computer analyzed thallium-201 imaging was compared in 124 patients with 1-vessel coronary artery disease (CAD). Of these, 78 had left anterior descending (LAD), 32 right and 14 left circumflex (LC) CAD. In patients with no previous myocardial infarction (MI), thallium imaging was more sensitive than the electrocardiogram (78% vs 64%, p <0.01), but in patients with previous MI, sensitivity was similar. Further, thallium imaging was more sensitive only in LAD and LC disease. Redistribution was compared with ST-segment depression as a marker of ischemia. Only in patients with prior MI (76% vs 44%, p <0.01) and only in LC and right CAD did redistribution occur more often than ST depression. Thallium imaging was more accurate in localizing stenoses than the electrocardiogram (p <0.001), but did not always correctly predict coronary anatomy. Septal thallium defects were associated with LAD disease in 84%, inferior defects with right CAD in 40% and posterolateral lesion defects with LC CAD in 22%. The results indicate the overall superiority of thallium imaging in 1-vessel CAD compared with exercise electrocardiography; however, there is a wide spectrum of extent and location of perfusion defects associated with each coronary artery. Thallium imaging complements coronary angiography by demonstrating the functional impact of CAD on myocardial perfusion.