Quantitative study of the pulmonary uptake of thallium 201 during exercise and redistribution in the coronary patient
Ollivier, J.P.; Gaillard, J.F.; Jobic, Y.; Bureau, J.F.; de Bourayne, J.; Brion, R.
Archives des Maladies du Coeur et des Vaisseaux 80(13): 1873-1879
1987
ISSN/ISBN: 0003-9683 PMID: 3130005 Document Number: 292624
In some patients with coronary disease hyperactivity of the lungs is commonly observed when the myocardial scintigraphic images are recorded during exercise. Pulmonary activity of radionuclide tracers has been reported in the literature and quantified in different ways. The present study contributes to this quantification by suggesting a new index: the pulmonary activity to cardiac activity percentages ratio during exercise and blood redistribution. The value of the new index has been evaluated comparatively in 11 subjects with normal coronary arteries (0.76 +/- 0.09) and in 39 patients with angiographically proven coronary disease (0.92 +/- 0.10; p less than 0.001). Remarkably, this index hardly varies in normal subjects and therefore is a highly specific aid to diagnosis. In coronary patients, multivariate analysis has shown that it correlates in decreasing order of intensity with: (1) a left ventricular end-diastolic pressure of 14 mmHg or more; (2) a moderate rise in heart rate at exercise; (3) a moderate heart work; (4) an ST depression of 2 mm or more; (5) a multilocular myocardial ischaemia at scintigraphy. Our index did not prove capable of discriminating between one-, two- or three- vessel diseases. In view of the data obtained in this study and those found in the literature, this index should be regarded as a reliable marker of left ventricular dysfunction during stress. Being relatively inexpensive and easy to obtain, it complements myocardial scintigraphy and may be useful in clinical practice.