Increased exercise thallium-201 lung uptake: A noninvasive prognostic index in two-vessel coronary artery disease

D. D. Miller, S. Kaul, H. W. Strauss, J. B. Newell, R. D. Okada, C. A. Boucher

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

To determine the physiologic impact of two-vessel coronary artery disease and its effect on prognosis, a series of clinical, angiographic, exercise and quantitative thallium-201 (Tl-201) imaging parameters were analyzed in 85 consecutive two-vessel coronary artery disease patients followed for 52 ± 27 months after coronary angiography and Tl-201 scintigraphy. End points were cardiac death (n = 3), myocardial infarction (n = 6) and coronary bypass graft surgery more than three months after testing (n = 16). Using Cox Hazards survival analysis, early cardiac events were not predicted by: myocardial infarction or anginal history; resting left ventricular function; exercise blood pressure response; angina or severity of ECG ST segment depression (mm); Tl-201 defect size; redistribution or clearance; angiographic patterns; or the presence of proximal left anterior descending disease. Significant predictors of adverse cardiac events were: increased exercise lung to heart Tl-201 ratio (0.59 ± 0.12 versus 0.46 ± 0.1; P < 0.0001); ECG lead extent of ST segment depression (P < 0.03); and exercise heart rate response (P < 0.047). Event-free survival for patients with normal and abnormally increased lung to heart Tl-201 ratios at 48 months was 76% versus 63% (P < 0.003). It was concluded that two-vessel coronary artery disease survival correlates with exercise Tl-201 uptake which reflects exercise induced left ventricular dysfunction.

Original languageEnglish (US)
Pages (from-to)270-276
Number of pages7
JournalCanadian Journal of Cardiology
Volume4
Issue number6
Publication statusPublished - Jan 1 1988
Externally publishedYes

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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