ASSESSMENT OF LEFT VENTRICULAR DYSFUNCTION BY THALLIUM-201 LUNG UPTAKE DURING EXERCISE IN CORONARY ARTERY DISEASE

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To determine the clinical significance of an increased thallium-201 (Tl-201) activity in the lung and of its clearance from the lung after exercise, computer-quantitated Tl-201 lung activity was measured and compared with hemodynamic parameters at rest and during exercise in 25 patients with coronary artery disease (CAD). All patients underwent a supine bicycle ergometer exercise test and mean pulmonary artery wedge pressure (PAWP) was measured by a Swan-Ganz catheter. Coronary angiography was also performed. On computer-generated initial and 2 and a half hours delayed anterior images, regions of interest were selected over the myocardium (M) and lung (L), and the initial L/M ratio and the (initial L)/(delayed L) ratio were calculated as indices of an increased Tl-201 lung uptake and lung clearance, respectively. The initial L/M ratio and the (initial L)/(delayed L) ratio had no significant correlation with mean PAWP at rest and had a weak negative correlation with the resting ejection fraction (r=-0.57 and r=-0.58, respectively). However, both ratios showed good correlations with mean PAWP during peak exercise (r=0.85 and r=0.80, respectively), suggesting that they provide useful indices for assessing the severity of exercise-induced left ventricular dysfunction.
社団法人日本循環器学会の論文
1983-04-20