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Exercise thallium-201 single photon emission computed tomography for evaluation of coronary artery bypass graft patency
Thallium-201 single photon emission computed tomography (SPECT) is superior to planar imaging for localizing native coronary stenoses, but has not yet been studied for assessing graft patency late after coronary artery bypass graft surgery (CABG). Accordingly, we studied 50 patients (40 males), aged...
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| Published in: | The American journal of cardiology 1995-07, Vol.76 (3), p.107-111 |
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| creator | Lakkis, Nasser M. Mahmarian, John J. Verani, Mario S. |
| description | Thallium-201 single photon emission computed tomography (SPECT) is superior to planar imaging for localizing native coronary stenoses, but has not yet been studied for assessing graft patency late after coronary artery bypass graft surgery (CABG). Accordingly, we studied 50 patients (40 males), aged 58 ± 9 years (mean ± SD), who presented for evaluation of angina (30 patients), atypical chest pain (20 patients), and other symptoms (9 patients), late after CABG (51 ± 47 months). Patients with prior myocardial infarction were excluded. The mean ejection fraction was 58 ± 17%. All patients underwent coronary angiography within 3 weeks of symptom-limited exercise thallium-201 SPECT. There were 119 grafts, of which 48 had >50% stenosis by angiography. Thallium-201 SPECT detected 40 of these 48 (83%) stenosed grafts. The sensitivity of thallium-201 SPECT for detecting any graft stenosis was higher than that of the exercise electrocardiogram in patients with typical recurrent angina (84% vs 24%, p < 0.0001), as well as in those with atypical symptoms (70% vs 50%, p = 0.0039). The sensitivity of thallium-201 SPECT for correctly localizing the graft stenosis site was 82% for the left anterior descending, 92% for the right coronary, and 75% for the circumflex coronary artery. In conclusion, exercise thallium-201 SPECT is an excellent method to detect and localize graft stenosis late after CABG; it is far superior to the exercise electrocardiogram alone, both in patients with and without typical recurrent angina. |
| doi_str_mv | 10.1016/S0002-9149(99)80039-3 |
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Accordingly, we studied 50 patients (40 males), aged 58 ± 9 years (mean ± SD), who presented for evaluation of angina (30 patients), atypical chest pain (20 patients), and other symptoms (9 patients), late after CABG (51 ± 47 months). Patients with prior myocardial infarction were excluded. The mean ejection fraction was 58 ± 17%. All patients underwent coronary angiography within 3 weeks of symptom-limited exercise thallium-201 SPECT. There were 119 grafts, of which 48 had >50% stenosis by angiography. Thallium-201 SPECT detected 40 of these 48 (83%) stenosed grafts. The sensitivity of thallium-201 SPECT for detecting any graft stenosis was higher than that of the exercise electrocardiogram in patients with typical recurrent angina (84% vs 24%, p < 0.0001), as well as in those with atypical symptoms (70% vs 50%, p = 0.0039). The sensitivity of thallium-201 SPECT for correctly localizing the graft stenosis site was 82% for the left anterior descending, 92% for the right coronary, and 75% for the circumflex coronary artery. In conclusion, exercise thallium-201 SPECT is an excellent method to detect and localize graft stenosis late after CABG; it is far superior to the exercise electrocardiogram alone, both in patients with and without typical recurrent angina.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/S0002-9149(99)80039-3</identifier><identifier>PMID: 7611141</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Angina Pectoris - diagnostic imaging ; Angioplasty ; Biological and medical sciences ; Cardiovascular system ; Chest Pain - diagnostic imaging ; Chi-Square Distribution ; Coronary Angiography - statistics & numerical data ; Coronary Artery Bypass ; Coronary vessels ; Electrocardiography ; Exercise Test - methods ; Exercise Test - statistics & numerical data ; Female ; Follow-Up Studies ; Graft Occlusion, Vascular - diagnostic imaging ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Radionuclide investigations ; Thallium Radioisotopes ; Tomography ; Tomography, Emission-Computed, Single-Photon - methods ; Tomography, Emission-Computed, Single-Photon - statistics & numerical data</subject><ispartof>The American journal of cardiology, 1995-07, Vol.76 (3), p.107-111</ispartof><rights>1995 Excerpta Medica, Inc. All rights reserved under the United States, International, and Pan-American Copyright Conventions.</rights><rights>1995 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. 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Accordingly, we studied 50 patients (40 males), aged 58 ± 9 years (mean ± SD), who presented for evaluation of angina (30 patients), atypical chest pain (20 patients), and other symptoms (9 patients), late after CABG (51 ± 47 months). Patients with prior myocardial infarction were excluded. The mean ejection fraction was 58 ± 17%. All patients underwent coronary angiography within 3 weeks of symptom-limited exercise thallium-201 SPECT. There were 119 grafts, of which 48 had >50% stenosis by angiography. Thallium-201 SPECT detected 40 of these 48 (83%) stenosed grafts. The sensitivity of thallium-201 SPECT for detecting any graft stenosis was higher than that of the exercise electrocardiogram in patients with typical recurrent angina (84% vs 24%, p < 0.0001), as well as in those with atypical symptoms (70% vs 50%, p = 0.0039). The sensitivity of thallium-201 SPECT for correctly localizing the graft stenosis site was 82% for the left anterior descending, 92% for the right coronary, and 75% for the circumflex coronary artery. In conclusion, exercise thallium-201 SPECT is an excellent method to detect and localize graft stenosis late after CABG; it is far superior to the exercise electrocardiogram alone, both in patients with and without typical recurrent angina.</description><subject>Aged</subject><subject>Angina Pectoris - diagnostic imaging</subject><subject>Angioplasty</subject><subject>Biological and medical sciences</subject><subject>Cardiovascular system</subject><subject>Chest Pain - diagnostic imaging</subject><subject>Chi-Square Distribution</subject><subject>Coronary Angiography - statistics & numerical data</subject><subject>Coronary Artery Bypass</subject><subject>Coronary vessels</subject><subject>Electrocardiography</subject><subject>Exercise Test - methods</subject><subject>Exercise Test - statistics & numerical data</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Graft Occlusion, Vascular - diagnostic imaging</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Radionuclide investigations</subject><subject>Thallium Radioisotopes</subject><subject>Tomography</subject><subject>Tomography, Emission-Computed, Single-Photon - methods</subject><subject>Tomography, Emission-Computed, Single-Photon - statistics & numerical data</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><recordid>eNqFkU1v1DAQhi0EKtvCT6hkIYTgELDjr_iEUFU-pEocgLPlOOOuqyQOttOy_x5vd7UHLlw8Hs0zr2bmReiSkveUUPnhByGkbTTl-q3W7zpCmG7YE7ShndIN1ZQ9RZsT8hyd53xXU0qFPENnSlJKOd2gh-s_kFzIgMvWjmNYp6YlFOcw346Al20sccYwhZxD_bg4LWuBAZc4xdtkl-0O-5gw3NtxtWWPRF-pFGebdtimAjX0u8XmjCvvC15sgdntXqBn3o4ZXh7jBfr1-frn1dfm5vuXb1efbhrHtCoNSCa4baXlvXNUWAKaisGLdpB9x33HQDsPg6Wa9PVRXnHeir6VQgjeqo5doDcH3SXF3yvkYuouDsbRzhDXbJRiXdcpWcFX_4B3cU1znc20jDChGd-riQPkUsw5gTdLClNd1VBi9q6YR1fM_uRGa_PoimG17_IovvYTDKeuow21_vpYt9nZ0Sc7V09OGJOEVesq9vGAQb3YfYBksgv1mjCEBK6YIYb_DPIXDyCqOA</recordid><startdate>19950715</startdate><enddate>19950715</enddate><creator>Lakkis, Nasser M.</creator><creator>Mahmarian, John J.</creator><creator>Verani, Mario S.</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>19950715</creationdate><title>Exercise thallium-201 single photon emission computed tomography for evaluation of coronary artery bypass graft patency</title><author>Lakkis, Nasser M. ; Mahmarian, John J. ; Verani, Mario S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c397t-e6354a26a4bcc15a0e915df52d6b84f83e9cfeda190ba197f74425b2655542783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Aged</topic><topic>Angina Pectoris - diagnostic imaging</topic><topic>Angioplasty</topic><topic>Biological and medical sciences</topic><topic>Cardiovascular system</topic><topic>Chest Pain - diagnostic imaging</topic><topic>Chi-Square Distribution</topic><topic>Coronary Angiography - statistics & numerical data</topic><topic>Coronary Artery Bypass</topic><topic>Coronary vessels</topic><topic>Electrocardiography</topic><topic>Exercise Test - methods</topic><topic>Exercise Test - statistics & numerical data</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Graft Occlusion, Vascular - diagnostic imaging</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Radionuclide investigations</topic><topic>Thallium Radioisotopes</topic><topic>Tomography</topic><topic>Tomography, Emission-Computed, Single-Photon - methods</topic><topic>Tomography, Emission-Computed, Single-Photon - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lakkis, Nasser M.</creatorcontrib><creatorcontrib>Mahmarian, John J.</creatorcontrib><creatorcontrib>Verani, Mario S.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lakkis, Nasser M.</au><au>Mahmarian, John J.</au><au>Verani, Mario S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Exercise thallium-201 single photon emission computed tomography for evaluation of coronary artery bypass graft patency</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>1995-07-15</date><risdate>1995</risdate><volume>76</volume><issue>3</issue><spage>107</spage><epage>111</epage><pages>107-111</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Thallium-201 single photon emission computed tomography (SPECT) is superior to planar imaging for localizing native coronary stenoses, but has not yet been studied for assessing graft patency late after coronary artery bypass graft surgery (CABG). Accordingly, we studied 50 patients (40 males), aged 58 ± 9 years (mean ± SD), who presented for evaluation of angina (30 patients), atypical chest pain (20 patients), and other symptoms (9 patients), late after CABG (51 ± 47 months). Patients with prior myocardial infarction were excluded. The mean ejection fraction was 58 ± 17%. All patients underwent coronary angiography within 3 weeks of symptom-limited exercise thallium-201 SPECT. There were 119 grafts, of which 48 had >50% stenosis by angiography. Thallium-201 SPECT detected 40 of these 48 (83%) stenosed grafts. The sensitivity of thallium-201 SPECT for detecting any graft stenosis was higher than that of the exercise electrocardiogram in patients with typical recurrent angina (84% vs 24%, p < 0.0001), as well as in those with atypical symptoms (70% vs 50%, p = 0.0039). The sensitivity of thallium-201 SPECT for correctly localizing the graft stenosis site was 82% for the left anterior descending, 92% for the right coronary, and 75% for the circumflex coronary artery. In conclusion, exercise thallium-201 SPECT is an excellent method to detect and localize graft stenosis late after CABG; it is far superior to the exercise electrocardiogram alone, both in patients with and without typical recurrent angina.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>7611141</pmid><doi>10.1016/S0002-9149(99)80039-3</doi><tpages>5</tpages></addata></record> |
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| subjects | Aged Angina Pectoris - diagnostic imaging Angioplasty Biological and medical sciences Cardiovascular system Chest Pain - diagnostic imaging Chi-Square Distribution Coronary Angiography - statistics & numerical data Coronary Artery Bypass Coronary vessels Electrocardiography Exercise Test - methods Exercise Test - statistics & numerical data Female Follow-Up Studies Graft Occlusion, Vascular - diagnostic imaging Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Radionuclide investigations Thallium Radioisotopes Tomography Tomography, Emission-Computed, Single-Photon - methods Tomography, Emission-Computed, Single-Photon - statistics & numerical data |
| title | Exercise thallium-201 single photon emission computed tomography for evaluation of coronary artery bypass graft patency |
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