Quantitative severity of stress thallium-201 myocardial perfusion single-photon emission computed tomography defects in one-vessel coronary artery disease

Am J Cardiol. 1993 Aug 1;72(3):273-9. doi: 10.1016/0002-9149(93)90672-y.

Abstract

The relation between the quantitative myocardial perfusion defect severity of exercise thallium-201 single-photon emission computed tomography (SPECT) and the quantitative degree of coronary stenosis was examined in 18 patients with 1-vessel disease (> or = 50% diameter stenosis), and abnormal thallium-201 SPECT. A total of 26 vessels were analyzed. Thallium-201 SPECT quantitative defect severity score was derived by summing the number of pixels in a coronary territory in which counts fell below the normal mean and multiplied by the number of SDs by which they fell below the normal mean. The thallium-201 defect severity score was significantly (p < 0.001) related to the maximal percent luminal diameter narrowing (r = 0.93), percent area narrowing (r = 0.89), absolute stenotic area (r = 0.79), and absolute stenotic diameter (r = 0.81). As expected, the strongest relation between thallium-201 defect severity and quantitative angiographic indexes was in the low and high ranges of coronary stenosis, with more variability and lower correlation coefficients (percent diameter: r = 0.75, p < 0.02, percent area stenosis: r = 0.63, p < 0.05) in the middle ranges (50 to 80% diameter stenosis). This observation is likely to be due to the complex flow characteristics across stenotic lesions. The findings suggest that in a select population, thallium-201 defect severity is potentially useful for noninvasive characterization of the functional severity of coronary artery stenosis and may complement coronary angiography in predicting functionally significant stenosis.

Publication types

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

MeSH terms

  • Adult
  • Aged
  • Coronary Angiography / statistics & numerical data
  • Coronary Disease / diagnostic imaging*
  • Coronary Disease / epidemiology
  • Exercise Test / instrumentation
  • Exercise Test / methods*
  • Exercise Test / statistics & numerical data
  • Female
  • Heart / diagnostic imaging*
  • Humans
  • Male
  • Middle Aged
  • Regression Analysis
  • Severity of Illness Index
  • Thallium Radioisotopes*
  • Tomography, Emission-Computed, Single-Photon / instrumentation
  • Tomography, Emission-Computed, Single-Photon / methods*
  • Tomography, Emission-Computed, Single-Photon / statistics & numerical data

Substances

  • Thallium Radioisotopes