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  • Title: Adenosine coronary vasodilation in coronary artery disease: technetium-99m tetrofosmin myocardial tomography versus echocardiography.
    Author: Cuocolo A, Sullo P, Pace L, Nappi A, Gisonni P, Nicolai E, Trimarco B, Salvatore M.
    Journal: J Nucl Med; 1997 Jul; 38(7):1089-94. PubMed ID: 9225796.
    Abstract:
    UNLABELLED: This study compared the results of adenosine 99mTc-tetrofosmin cardiac tomography with those of adenosine echocardiography in identifying patients with coronary artery disease (CAD) and in localizing individual stenosed, coronary vessels. METHODS: Twenty-six consecutive patients with suspected or known CAD had simultaneous adenosine (140 micrograms/Kg/min intravenously) 99mTc-tetrofosmin tomography and two-dimensional echocardiography. All patients had coronary angiography within 4 wk from imaging studies. Regional 99mTc-tetrofosmin activity was quantitatively measured in 78 coronary vascular territories and echocardiographic left ventricular function was assessed in corresponding regions. RESULTS: At coronary angiography one patient had normal coronary vessels, 12 patients one-vessel and 13 had multivessel disease (> or = 50% luminal stenosis). Among the 25 patients with CAD, 22 showed perfusion defects at adenosine 99mTc-tetrofosmin tomography (sensitivity 88%) and 17 had abnormal echocardiographic study (sensitivity 68%, p < 0.05 versus 99mTc-tetrofosmin). Agreement for the identification of patients with CAD between adenosine 99mTc-tetrofosmin tomography and echocardiography was observed in 21 (81%) of the total 26 patients, with a kappa value of 0.45. Overall sensitivity, specificity and diagnostic accuracy for detection of individual stenosed vessels were 79%, 88% and 83% for 99mTc tetrofosmin and 57%, 68% and 61% (all p < 0.05 versus 99mTc-tetrofosmin) for echocardiography. Concordance between adenosine 99mTc-tetrofosmin tomography and echocardiography in the detection of individual stenosed coronary vessels was observed in 57 (73%) of the 78 vascular territories, with a kappa value of 0.36. CONCLUSION: Adenosine-induced coronary vasodilation associated with quantitative 99mTc-tetrofosmin tomography is more accurate than adenosine echocardiography in identifying patients with CAD and in detecting individual stenosed coronary vessels.
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