Comparison of exercise, dipyridamole, and adenosine by use of technetium 99m sestamibi tomographic imaging

Carlo D. Santos-Ocampo, Steven D. Herman, Mark I. Travin, Carol Ewing Garber, Alan W. Ahlberg, Debra E. Messinger, Gary V. Heller

Research output: Contribution to journalArticle

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Abstract

Background: Pharmacologic stress has been shown in animal studies to induce high degrees of myocardial hyperemia. At these levels of myocardial blood flow, the myocardial uptake of technetium 99m sestamibi may plateau and may affect the diagnostic accuracy. This study compared the effects of myocardial hyperemia induced by exercise, dipyridamole, and adenosine on99mTc sestamibi tomographic imaging in normal subjects and patients with ischemic coronary artery disease. Methods and Results: Twenty subjects (group I, 10 normal subjects; group II, 10 patients with known coronary artery disease) underwent99mTc sestamibi tomographic imaging after rest, exercise, dipyridamole infusion, and adenosine infusions on separate occasions. Total and background-corrected myocardial counts of the resulting images were calculated. Visual and computer-generated quantitative myocardial perfusion defect analysis was performed in subjects in group II. For subjects in both groups I and II, there were no significant differences in the background-corrected myocardial counts obtained with exercise, dipyridamole, and adenosine stress. There were no significant differences in the myocardial perfusion defects obtained after the three different modes of stress, including percentage defect size, stress deficit percentage, percentage of ischemia, count deficit index, and defect nadir. Conclusions: The myocardial uptake of99mTc sestamibi in normal subjects and patients with coronary artery disease is comparable after exercise, dipyridamole, and adenosine stress. In addition, the defect sizes and intensities with99mTc sestamibi after all forms of stress were equivalent. Thus99mTc sestamibi, in combination with either adenosine or dipyridamole infusions, provides imaging data equivalent to those with exercise and may be considered an alternative in patients unable to undergo adequate exercise.

Original languageEnglish (US)
Pages (from-to)57-64
Number of pages8
JournalJournal of Nuclear Cardiology
Volume1
Issue number1
DOIs
StatePublished - Jan 1994
Externally publishedYes

Fingerprint

Technetium Tc 99m Sestamibi
Dipyridamole
Adenosine
Exercise
Coronary Artery Disease
Hyperemia
Perfusion
Ischemia

Keywords

  • adenosine
  • dipyridamole
  • exercise
  • pharmacologic stress
  • sestamibi imaging

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Santos-Ocampo, C. D., Herman, S. D., Travin, M. I., Garber, C. E., Ahlberg, A. W., Messinger, D. E., & Heller, G. V. (1994). Comparison of exercise, dipyridamole, and adenosine by use of technetium 99m sestamibi tomographic imaging. Journal of Nuclear Cardiology, 1(1), 57-64. https://doi.org/10.1007/BF02940012

Comparison of exercise, dipyridamole, and adenosine by use of technetium 99m sestamibi tomographic imaging. / Santos-Ocampo, Carlo D.; Herman, Steven D.; Travin, Mark I.; Garber, Carol Ewing; Ahlberg, Alan W.; Messinger, Debra E.; Heller, Gary V.

In: Journal of Nuclear Cardiology, Vol. 1, No. 1, 01.1994, p. 57-64.

Research output: Contribution to journalArticle

Santos-Ocampo, CD, Herman, SD, Travin, MI, Garber, CE, Ahlberg, AW, Messinger, DE & Heller, GV 1994, 'Comparison of exercise, dipyridamole, and adenosine by use of technetium 99m sestamibi tomographic imaging', Journal of Nuclear Cardiology, vol. 1, no. 1, pp. 57-64. https://doi.org/10.1007/BF02940012
Santos-Ocampo, Carlo D. ; Herman, Steven D. ; Travin, Mark I. ; Garber, Carol Ewing ; Ahlberg, Alan W. ; Messinger, Debra E. ; Heller, Gary V. / Comparison of exercise, dipyridamole, and adenosine by use of technetium 99m sestamibi tomographic imaging. In: Journal of Nuclear Cardiology. 1994 ; Vol. 1, No. 1. pp. 57-64.
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abstract = "Background: Pharmacologic stress has been shown in animal studies to induce high degrees of myocardial hyperemia. At these levels of myocardial blood flow, the myocardial uptake of technetium 99m sestamibi may plateau and may affect the diagnostic accuracy. This study compared the effects of myocardial hyperemia induced by exercise, dipyridamole, and adenosine on99mTc sestamibi tomographic imaging in normal subjects and patients with ischemic coronary artery disease. Methods and Results: Twenty subjects (group I, 10 normal subjects; group II, 10 patients with known coronary artery disease) underwent99mTc sestamibi tomographic imaging after rest, exercise, dipyridamole infusion, and adenosine infusions on separate occasions. Total and background-corrected myocardial counts of the resulting images were calculated. Visual and computer-generated quantitative myocardial perfusion defect analysis was performed in subjects in group II. For subjects in both groups I and II, there were no significant differences in the background-corrected myocardial counts obtained with exercise, dipyridamole, and adenosine stress. There were no significant differences in the myocardial perfusion defects obtained after the three different modes of stress, including percentage defect size, stress deficit percentage, percentage of ischemia, count deficit index, and defect nadir. Conclusions: The myocardial uptake of99mTc sestamibi in normal subjects and patients with coronary artery disease is comparable after exercise, dipyridamole, and adenosine stress. In addition, the defect sizes and intensities with99mTc sestamibi after all forms of stress were equivalent. Thus99mTc sestamibi, in combination with either adenosine or dipyridamole infusions, provides imaging data equivalent to those with exercise and may be considered an alternative in patients unable to undergo adequate exercise.",
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AU - Garber, Carol Ewing

AU - Ahlberg, Alan W.

AU - Messinger, Debra E.

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N2 - Background: Pharmacologic stress has been shown in animal studies to induce high degrees of myocardial hyperemia. At these levels of myocardial blood flow, the myocardial uptake of technetium 99m sestamibi may plateau and may affect the diagnostic accuracy. This study compared the effects of myocardial hyperemia induced by exercise, dipyridamole, and adenosine on99mTc sestamibi tomographic imaging in normal subjects and patients with ischemic coronary artery disease. Methods and Results: Twenty subjects (group I, 10 normal subjects; group II, 10 patients with known coronary artery disease) underwent99mTc sestamibi tomographic imaging after rest, exercise, dipyridamole infusion, and adenosine infusions on separate occasions. Total and background-corrected myocardial counts of the resulting images were calculated. Visual and computer-generated quantitative myocardial perfusion defect analysis was performed in subjects in group II. For subjects in both groups I and II, there were no significant differences in the background-corrected myocardial counts obtained with exercise, dipyridamole, and adenosine stress. There were no significant differences in the myocardial perfusion defects obtained after the three different modes of stress, including percentage defect size, stress deficit percentage, percentage of ischemia, count deficit index, and defect nadir. Conclusions: The myocardial uptake of99mTc sestamibi in normal subjects and patients with coronary artery disease is comparable after exercise, dipyridamole, and adenosine stress. In addition, the defect sizes and intensities with99mTc sestamibi after all forms of stress were equivalent. Thus99mTc sestamibi, in combination with either adenosine or dipyridamole infusions, provides imaging data equivalent to those with exercise and may be considered an alternative in patients unable to undergo adequate exercise.

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