Changes in the left ventricular ejection fraction during exercise and in the thallium-201 perfusion after administration of dipyridamole in patients with coronary disease
Schmoliner, R.; Dudczak, R.; Kronik, G.; Homan, R.; Mösslacher, H.
Wiener Klinische Wochenschrift 96(9): 343-349
1984
ISSN/ISBN: 0043-5325 PMID: 6475085 Document Number: 240740
46 patients with coronary artery disease (at least 70% stenoses) were studied with thallium-201 imaging following dipyridamole (0.50 mg/kg bodyweight intravenously) with 4-hour control and by radionuclide ventriculography at rest and during symptom-limited bicycle exercise in supine position. 38 patients (83%) had positive thallium-201 findings with persistent defects in 18 and transient defects in 20 cases. Mean left ventricular ejection fraction (EF) fell during exercise from 56.1% +/- 13.3 to 50.2% +/- 14.5 (p less than 0.001). 43 patients (93%) showed an abnormal EF response to exercise (rise of less than 10% of the control EF during exercise). In 8 patients with false negative thallium-findings the EF did not change from rest to exercise (64.1% +/- 10.0 vs. 64.6% +/- 8.5), however, in the 20 patients with transient Tl-201 defects a significant fall of the EF was noted (60.8% +/- 9.1 vs. 49.8% +/- 10.9, p less than 0.001), in the 18 patients with persistent defects only a slight decrease of the EF was induced with exercise (47.3% +/- 14.0 vs. 44.2% +/- 16.1, p less than 0.02). Thus transient Tl-201 defects usually predict functional impairment of the left ventricle with exercise, persistent defects suggest impaired rest function with only minor further dysfunction during exercise. Compared with rest and exercise ECG in these patients, both radionuclide techniques showed a significantly higher sensitivity.