Demonstration of differential post-stenotic myocardial technetium-99m-teboroxime clearance kinetics after experimental ischemia and hyperemic stress

R. E. Stewart, B. Heyl, R. A. O'Rourke, R. Blumhardt, Donald D Miller

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

The clearance kinetics of the perfusion tracer 99mTc-teboroxime were evaluated in post-stenotic and normal myocardium using dynamic planar gamma camera imaging in pre-instrumented dogs in the control state (n = 9) and following total occlusion (2 min), pharmacologic stress with adenosine [80 and 160 μg/kg/min] or dipyridamole, and rapid atrial pacing (220/min). Technetium-99m-teboroxime clearance in normal myocardium was accelerated by adenosine and by dipyridamole compared to the control state (8.9 ± 1.1 and 9.3 ± 1.9 min versus 11.9 ± 1.8 min; p < 0.05). Post-stenotic 99mTc-teboroxime clearance half-time was most significantly prolonged compared to nonoccluded contralateral perfusion zones by 160 μg/kg/min adenosine stress (11.2 ± 3.7 versus 6.3 ± 1.5 min) and by complete coronary occlusion (12.1 ± 3.3 versus 6.6 ± 1.2 min; both p < 0.05). Differential tracer clearance from post-stenotic versus nonoccluded zones produced quantitative evidence of relative defect 'redistribution' in 71% of maximal stress studies at a mean of 8.8 ± 2.5 min postinjection. Sensitivity, specificity, and diagnostic accuracy of prolonged regional 99mTc-teboroxime clearance rates for post-stenotic perfusion abnormalities were 62%, 100% and 81% in maximal stress studies. Future clinical trials of exercise and nonexercise stress 99mTc-teboroxime imaging should consider these kinetic characteristics and examine the correlates of perfusion defect 'redistribution.'

Original languageEnglish (US)
Pages (from-to)2000-2008
Number of pages9
JournalJournal of Nuclear Medicine
Volume32
Issue number10
StatePublished - Jan 1 1991
Externally publishedYes

Fingerprint

Technetium
Ischemia
Perfusion
Adenosine
Dipyridamole
Myocardium
Coronary Occlusion
Radionuclide Imaging
Clinical Trials
Dogs
Sensitivity and Specificity
technetium Tc 99m teboroxime

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Demonstration of differential post-stenotic myocardial technetium-99m-teboroxime clearance kinetics after experimental ischemia and hyperemic stress. / Stewart, R. E.; Heyl, B.; O'Rourke, R. A.; Blumhardt, R.; Miller, Donald D.

In: Journal of Nuclear Medicine, Vol. 32, No. 10, 01.01.1991, p. 2000-2008.

Research output: Contribution to journalArticle

@article{d482a72ec7364bb1ba7e9caa81250cc9,
title = "Demonstration of differential post-stenotic myocardial technetium-99m-teboroxime clearance kinetics after experimental ischemia and hyperemic stress",
abstract = "The clearance kinetics of the perfusion tracer 99mTc-teboroxime were evaluated in post-stenotic and normal myocardium using dynamic planar gamma camera imaging in pre-instrumented dogs in the control state (n = 9) and following total occlusion (2 min), pharmacologic stress with adenosine [80 and 160 μg/kg/min] or dipyridamole, and rapid atrial pacing (220/min). Technetium-99m-teboroxime clearance in normal myocardium was accelerated by adenosine and by dipyridamole compared to the control state (8.9 ± 1.1 and 9.3 ± 1.9 min versus 11.9 ± 1.8 min; p < 0.05). Post-stenotic 99mTc-teboroxime clearance half-time was most significantly prolonged compared to nonoccluded contralateral perfusion zones by 160 μg/kg/min adenosine stress (11.2 ± 3.7 versus 6.3 ± 1.5 min) and by complete coronary occlusion (12.1 ± 3.3 versus 6.6 ± 1.2 min; both p < 0.05). Differential tracer clearance from post-stenotic versus nonoccluded zones produced quantitative evidence of relative defect 'redistribution' in 71{\%} of maximal stress studies at a mean of 8.8 ± 2.5 min postinjection. Sensitivity, specificity, and diagnostic accuracy of prolonged regional 99mTc-teboroxime clearance rates for post-stenotic perfusion abnormalities were 62{\%}, 100{\%} and 81{\%} in maximal stress studies. Future clinical trials of exercise and nonexercise stress 99mTc-teboroxime imaging should consider these kinetic characteristics and examine the correlates of perfusion defect 'redistribution.'",
author = "Stewart, {R. E.} and B. Heyl and O'Rourke, {R. A.} and R. Blumhardt and Miller, {Donald D}",
year = "1991",
month = "1",
day = "1",
language = "English (US)",
volume = "32",
pages = "2000--2008",
journal = "Journal of Nuclear Medicine",
issn = "0161-5505",
publisher = "Society of Nuclear Medicine Inc.",
number = "10",

}

TY - JOUR

T1 - Demonstration of differential post-stenotic myocardial technetium-99m-teboroxime clearance kinetics after experimental ischemia and hyperemic stress

AU - Stewart, R. E.

AU - Heyl, B.

AU - O'Rourke, R. A.

AU - Blumhardt, R.

AU - Miller, Donald D

PY - 1991/1/1

Y1 - 1991/1/1

N2 - The clearance kinetics of the perfusion tracer 99mTc-teboroxime were evaluated in post-stenotic and normal myocardium using dynamic planar gamma camera imaging in pre-instrumented dogs in the control state (n = 9) and following total occlusion (2 min), pharmacologic stress with adenosine [80 and 160 μg/kg/min] or dipyridamole, and rapid atrial pacing (220/min). Technetium-99m-teboroxime clearance in normal myocardium was accelerated by adenosine and by dipyridamole compared to the control state (8.9 ± 1.1 and 9.3 ± 1.9 min versus 11.9 ± 1.8 min; p < 0.05). Post-stenotic 99mTc-teboroxime clearance half-time was most significantly prolonged compared to nonoccluded contralateral perfusion zones by 160 μg/kg/min adenosine stress (11.2 ± 3.7 versus 6.3 ± 1.5 min) and by complete coronary occlusion (12.1 ± 3.3 versus 6.6 ± 1.2 min; both p < 0.05). Differential tracer clearance from post-stenotic versus nonoccluded zones produced quantitative evidence of relative defect 'redistribution' in 71% of maximal stress studies at a mean of 8.8 ± 2.5 min postinjection. Sensitivity, specificity, and diagnostic accuracy of prolonged regional 99mTc-teboroxime clearance rates for post-stenotic perfusion abnormalities were 62%, 100% and 81% in maximal stress studies. Future clinical trials of exercise and nonexercise stress 99mTc-teboroxime imaging should consider these kinetic characteristics and examine the correlates of perfusion defect 'redistribution.'

AB - The clearance kinetics of the perfusion tracer 99mTc-teboroxime were evaluated in post-stenotic and normal myocardium using dynamic planar gamma camera imaging in pre-instrumented dogs in the control state (n = 9) and following total occlusion (2 min), pharmacologic stress with adenosine [80 and 160 μg/kg/min] or dipyridamole, and rapid atrial pacing (220/min). Technetium-99m-teboroxime clearance in normal myocardium was accelerated by adenosine and by dipyridamole compared to the control state (8.9 ± 1.1 and 9.3 ± 1.9 min versus 11.9 ± 1.8 min; p < 0.05). Post-stenotic 99mTc-teboroxime clearance half-time was most significantly prolonged compared to nonoccluded contralateral perfusion zones by 160 μg/kg/min adenosine stress (11.2 ± 3.7 versus 6.3 ± 1.5 min) and by complete coronary occlusion (12.1 ± 3.3 versus 6.6 ± 1.2 min; both p < 0.05). Differential tracer clearance from post-stenotic versus nonoccluded zones produced quantitative evidence of relative defect 'redistribution' in 71% of maximal stress studies at a mean of 8.8 ± 2.5 min postinjection. Sensitivity, specificity, and diagnostic accuracy of prolonged regional 99mTc-teboroxime clearance rates for post-stenotic perfusion abnormalities were 62%, 100% and 81% in maximal stress studies. Future clinical trials of exercise and nonexercise stress 99mTc-teboroxime imaging should consider these kinetic characteristics and examine the correlates of perfusion defect 'redistribution.'

UR - http://www.scopus.com/inward/record.url?scp=0026008836&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026008836&partnerID=8YFLogxK

M3 - Article

C2 - 1919745

AN - SCOPUS:0026008836

VL - 32

SP - 2000

EP - 2008

JO - Journal of Nuclear Medicine

JF - Journal of Nuclear Medicine

SN - 0161-5505

IS - 10

ER -