Alterations in myocardial thallium-201 distribution in patients with chronic systemic hypertension undergoing single-photon emission computed tomography
To characterize thallium-201 distribution in singlephoton emission computed tomography (SPECT) cardiac images and polar bullseye maps, 100 patients with chronic systemic hypertension due to end-stage renal disease were studied and the results compared with those in 35 normotensive control subjects....
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| Veröffentlicht in: | Am. J. Cardiol.; (United States) 1988-08, Vol.62 (4), p.234-238 |
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| container_title | Am. J. Cardiol.; (United States) |
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| creator | DePuey, E.Gordon Guertler-Krawczynska, E. Perkins, John V. Robbins, Wendy L. Whelchel, John D. Clements, Stephen D. |
| description | To characterize thallium-201 distribution in singlephoton emission computed tomography (SPECT) cardiac images and polar bullseye maps, 100 patients with chronic systemic hypertension due to end-stage renal disease were studied and the results compared with those in 35 normotensive control subjects. Thallium-201 SPECT was performed after exercise in all control subjects and 70 hypertensive patients, and after intravenous dipyridamole in 30 patients. A frequent finding in hypertensive patients was a fixed decrease in the normal lateral-to-septal count density ratio in immediate thallium-201 SPECT images (1.02 ± 0.10 vs 1.17 ± 0.08 in control subjects, p < 0.00001) and in 3-hour delayed images (1.02 ± 0.11 vs 1.11 ± 0.08 in control subjects, p < 0.00001). No significant difference in count density ratio was present in patients undergoing treadmill versus diypridamole intervention. In 35 patients the count density ratio was >2.0 standard deviations below the normal mean, creating the false impression of a fixed lateral defect (i.e., myocardial infarction).
In 12 patients, myocardial wall thickness was measured at end-diastole by 2-dimensional echocardiography. Wall thickness was increased (>11 mm) in all patients. The mean lateral-to-septal wall thickness ratio was 1.08 ± 1.11; in no patient was the ratio < 0.76 to indicate selective septal hypertrophy. The lateral-to-septal wall thickness and lateral-to-septal thallium-201 count density ratios correlated poorly (r = 0.43).
It is concluded that in hypertensive patients with diffuse myocardial hypertrophy there is a decrease in thallium-201 count density ratio in SPECT images, frequently creating apparent lateral wall fixed defects and mimicking myocardial infarction. |
| doi_str_mv | 10.1016/0002-9149(88)90218-4 |
| format | Article |
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In 12 patients, myocardial wall thickness was measured at end-diastole by 2-dimensional echocardiography. Wall thickness was increased (>11 mm) in all patients. The mean lateral-to-septal wall thickness ratio was 1.08 ± 1.11; in no patient was the ratio < 0.76 to indicate selective septal hypertrophy. The lateral-to-septal wall thickness and lateral-to-septal thallium-201 count density ratios correlated poorly (r = 0.43).
It is concluded that in hypertensive patients with diffuse myocardial hypertrophy there is a decrease in thallium-201 count density ratio in SPECT images, frequently creating apparent lateral wall fixed defects and mimicking myocardial infarction.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/0002-9149(88)90218-4</identifier><identifier>PMID: 2969670</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Arterial hypertension. Arterial hypotension ; BETA DECAY RADIOISOTOPES ; Biological and medical sciences ; Blood and lymphatic vessels ; BODY ; Cardiology. Vascular system ; Cardiomegaly - diagnostic imaging ; CARDIOVASCULAR AGENTS ; CARDIOVASCULAR DISEASES ; CARDIOVASCULAR SYSTEM ; Clinical manifestations. Epidemiology. Investigative techniques. Etiology ; COMPUTERIZED TOMOGRAPHY ; DAYS LIVING RADIOISOTOPES ; DIAGNOSIS ; Diagnosis, Differential ; DIAGNOSTIC TECHNIQUES ; DIAGRAMS ; Dipyridamole ; DISEASES ; DRUGS ; Echocardiography ; ELECTROCARDIOGRAMS ; ELECTRON CAPTURE RADIOISOTOPES ; EMISSION COMPUTED TOMOGRAPHY ; EXERCISE ; Female ; HEART ; Heart - diagnostic imaging ; HEAVY NUCLEI ; Humans ; HYPERTENSION ; Hypertension - diagnostic imaging ; ISOMERIC TRANSITION ISOTOPES ; ISOTOPES ; Male ; Medical sciences ; MUSCLES ; MYOCARDIAL INFARCTION ; Myocardial Infarction - diagnostic imaging ; MYOCARDIUM ; Myocardium - metabolism ; NUCLEI ; ODD-EVEN NUCLEI ; ORGANS ; PATIENTS ; Physical Exertion ; RADIOISOTOPES ; RADIOLOGY AND NUCLEAR MEDICINE ; Risk Factors ; SECONDS LIVING RADIOISOTOPES ; SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY ; SYMPTOMS ; THALLIUM 201 ; THALLIUM ISOTOPES ; Thallium Radioisotopes ; TOMOGRAPHY ; Tomography, Emission-Computed ; UPTAKE ; VASCULAR DISEASES 550601 -- Medicine-- Unsealed Radionuclides in Diagnostics ; VASODILATORS</subject><ispartof>Am. J. Cardiol.; (United States), 1988-08, Vol.62 (4), p.234-238</ispartof><rights>1988</rights><rights>1988 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c328t-e7319a3956c7490660f07bb660cff616148b2a6a5c453caf0dd855221ecdba2b3</citedby><cites>FETCH-LOGICAL-c328t-e7319a3956c7490660f07bb660cff616148b2a6a5c453caf0dd855221ecdba2b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0002-9149(88)90218-4$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,885,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=7749777$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/2969670$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/6924340$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>DePuey, E.Gordon</creatorcontrib><creatorcontrib>Guertler-Krawczynska, E.</creatorcontrib><creatorcontrib>Perkins, John V.</creatorcontrib><creatorcontrib>Robbins, Wendy L.</creatorcontrib><creatorcontrib>Whelchel, John D.</creatorcontrib><creatorcontrib>Clements, Stephen D.</creatorcontrib><creatorcontrib>Emory Univ. School of Medicine, Atlanta, GA (USA)</creatorcontrib><title>Alterations in myocardial thallium-201 distribution in patients with chronic systemic hypertension undergoing single-photon emission computed tomography</title><title>Am. J. Cardiol.; (United States)</title><addtitle>Am J Cardiol</addtitle><description>To characterize thallium-201 distribution in singlephoton emission computed tomography (SPECT) cardiac images and polar bullseye maps, 100 patients with chronic systemic hypertension due to end-stage renal disease were studied and the results compared with those in 35 normotensive control subjects. Thallium-201 SPECT was performed after exercise in all control subjects and 70 hypertensive patients, and after intravenous dipyridamole in 30 patients. A frequent finding in hypertensive patients was a fixed decrease in the normal lateral-to-septal count density ratio in immediate thallium-201 SPECT images (1.02 ± 0.10 vs 1.17 ± 0.08 in control subjects, p < 0.00001) and in 3-hour delayed images (1.02 ± 0.11 vs 1.11 ± 0.08 in control subjects, p < 0.00001). No significant difference in count density ratio was present in patients undergoing treadmill versus diypridamole intervention. In 35 patients the count density ratio was >2.0 standard deviations below the normal mean, creating the false impression of a fixed lateral defect (i.e., myocardial infarction).
In 12 patients, myocardial wall thickness was measured at end-diastole by 2-dimensional echocardiography. Wall thickness was increased (>11 mm) in all patients. The mean lateral-to-septal wall thickness ratio was 1.08 ± 1.11; in no patient was the ratio < 0.76 to indicate selective septal hypertrophy. The lateral-to-septal wall thickness and lateral-to-septal thallium-201 count density ratios correlated poorly (r = 0.43).
It is concluded that in hypertensive patients with diffuse myocardial hypertrophy there is a decrease in thallium-201 count density ratio in SPECT images, frequently creating apparent lateral wall fixed defects and mimicking myocardial infarction.</description><subject>Arterial hypertension. Arterial hypotension</subject><subject>BETA DECAY RADIOISOTOPES</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>BODY</subject><subject>Cardiology. Vascular system</subject><subject>Cardiomegaly - diagnostic imaging</subject><subject>CARDIOVASCULAR AGENTS</subject><subject>CARDIOVASCULAR DISEASES</subject><subject>CARDIOVASCULAR SYSTEM</subject><subject>Clinical manifestations. Epidemiology. Investigative techniques. Etiology</subject><subject>COMPUTERIZED TOMOGRAPHY</subject><subject>DAYS LIVING RADIOISOTOPES</subject><subject>DIAGNOSIS</subject><subject>Diagnosis, Differential</subject><subject>DIAGNOSTIC TECHNIQUES</subject><subject>DIAGRAMS</subject><subject>Dipyridamole</subject><subject>DISEASES</subject><subject>DRUGS</subject><subject>Echocardiography</subject><subject>ELECTROCARDIOGRAMS</subject><subject>ELECTRON CAPTURE RADIOISOTOPES</subject><subject>EMISSION COMPUTED TOMOGRAPHY</subject><subject>EXERCISE</subject><subject>Female</subject><subject>HEART</subject><subject>Heart - diagnostic imaging</subject><subject>HEAVY NUCLEI</subject><subject>Humans</subject><subject>HYPERTENSION</subject><subject>Hypertension - diagnostic imaging</subject><subject>ISOMERIC TRANSITION ISOTOPES</subject><subject>ISOTOPES</subject><subject>Male</subject><subject>Medical sciences</subject><subject>MUSCLES</subject><subject>MYOCARDIAL INFARCTION</subject><subject>Myocardial Infarction - diagnostic imaging</subject><subject>MYOCARDIUM</subject><subject>Myocardium - metabolism</subject><subject>NUCLEI</subject><subject>ODD-EVEN NUCLEI</subject><subject>ORGANS</subject><subject>PATIENTS</subject><subject>Physical Exertion</subject><subject>RADIOISOTOPES</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>Risk Factors</subject><subject>SECONDS LIVING RADIOISOTOPES</subject><subject>SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY</subject><subject>SYMPTOMS</subject><subject>THALLIUM 201</subject><subject>THALLIUM ISOTOPES</subject><subject>Thallium Radioisotopes</subject><subject>TOMOGRAPHY</subject><subject>Tomography, Emission-Computed</subject><subject>UPTAKE</subject><subject>VASCULAR DISEASES 550601 -- Medicine-- Unsealed Radionuclides in Diagnostics</subject><subject>VASODILATORS</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1988</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kd2K1TAUhYMo43H0DRSKiOhFNUnb_NwIw-AfDHij1yFNdk8jbVKTVOmb-Limcw7n0pvshPXtzV5ZCD0n-B3BhL3HGNNakla-EeKtxJSIun2ADkRwWRNJmofocEEeoycp_SxPQjp2ha6oZJJxfEB_b6YMUWcXfKqcr-YtGB2t01OVRz1Nbp1rikllXcrR9esO7txSWsDnVP1xeazMGIN3pkpbyjCXy7gtEDP4tOOrtxCPwfljlcoxQb2MIRehoOmeMGFe1gy2ymEOx6iXcXuKHg16SvDsXK_Rj08fv99-qe--ff56e3NXm4aKXANviNSN7JjhrcSM4QHzvi_VDAMjjLSip5rpzrRdY_SArRVdRykBY3tN--YavTzNDSk7lYzLYEYTvAeTFZO0bVpcoNcnaInh1wopq7K5gWnSHsKaFBcNlQ0RBWxPoIkhpQiDWqKbddwUwWpPTe2RqD0SJYS6T021pe3Fef7az2AvTeeYiv7qrOtk9DRE7Y1LF4wX65zzgn04YVA-7LeDuPsBb8C6uNuxwf1_j3-bcrdM</recordid><startdate>19880801</startdate><enddate>19880801</enddate><creator>DePuey, E.Gordon</creator><creator>Guertler-Krawczynska, E.</creator><creator>Perkins, John V.</creator><creator>Robbins, Wendy L.</creator><creator>Whelchel, John D.</creator><creator>Clements, Stephen D.</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>19880801</creationdate><title>Alterations in myocardial thallium-201 distribution in patients with chronic systemic hypertension undergoing single-photon emission computed tomography</title><author>DePuey, E.Gordon ; Guertler-Krawczynska, E. ; Perkins, John V. ; Robbins, Wendy L. ; Whelchel, John D. ; Clements, Stephen D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c328t-e7319a3956c7490660f07bb660cff616148b2a6a5c453caf0dd855221ecdba2b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1988</creationdate><topic>Arterial hypertension. Arterial hypotension</topic><topic>BETA DECAY RADIOISOTOPES</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>BODY</topic><topic>Cardiology. Vascular system</topic><topic>Cardiomegaly - diagnostic imaging</topic><topic>CARDIOVASCULAR AGENTS</topic><topic>CARDIOVASCULAR DISEASES</topic><topic>CARDIOVASCULAR SYSTEM</topic><topic>Clinical manifestations. Epidemiology. Investigative techniques. Etiology</topic><topic>COMPUTERIZED TOMOGRAPHY</topic><topic>DAYS LIVING RADIOISOTOPES</topic><topic>DIAGNOSIS</topic><topic>Diagnosis, Differential</topic><topic>DIAGNOSTIC TECHNIQUES</topic><topic>DIAGRAMS</topic><topic>Dipyridamole</topic><topic>DISEASES</topic><topic>DRUGS</topic><topic>Echocardiography</topic><topic>ELECTROCARDIOGRAMS</topic><topic>ELECTRON CAPTURE RADIOISOTOPES</topic><topic>EMISSION COMPUTED TOMOGRAPHY</topic><topic>EXERCISE</topic><topic>Female</topic><topic>HEART</topic><topic>Heart - diagnostic imaging</topic><topic>HEAVY NUCLEI</topic><topic>Humans</topic><topic>HYPERTENSION</topic><topic>Hypertension - diagnostic imaging</topic><topic>ISOMERIC TRANSITION ISOTOPES</topic><topic>ISOTOPES</topic><topic>Male</topic><topic>Medical sciences</topic><topic>MUSCLES</topic><topic>MYOCARDIAL INFARCTION</topic><topic>Myocardial Infarction - diagnostic imaging</topic><topic>MYOCARDIUM</topic><topic>Myocardium - metabolism</topic><topic>NUCLEI</topic><topic>ODD-EVEN NUCLEI</topic><topic>ORGANS</topic><topic>PATIENTS</topic><topic>Physical Exertion</topic><topic>RADIOISOTOPES</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>Risk Factors</topic><topic>SECONDS LIVING RADIOISOTOPES</topic><topic>SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY</topic><topic>SYMPTOMS</topic><topic>THALLIUM 201</topic><topic>THALLIUM ISOTOPES</topic><topic>Thallium Radioisotopes</topic><topic>TOMOGRAPHY</topic><topic>Tomography, Emission-Computed</topic><topic>UPTAKE</topic><topic>VASCULAR DISEASES 550601 -- Medicine-- Unsealed Radionuclides in Diagnostics</topic><topic>VASODILATORS</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DePuey, E.Gordon</creatorcontrib><creatorcontrib>Guertler-Krawczynska, E.</creatorcontrib><creatorcontrib>Perkins, John V.</creatorcontrib><creatorcontrib>Robbins, Wendy L.</creatorcontrib><creatorcontrib>Whelchel, John D.</creatorcontrib><creatorcontrib>Clements, Stephen D.</creatorcontrib><creatorcontrib>Emory Univ. School of Medicine, Atlanta, GA (USA)</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>Am. J. Cardiol.; (United States)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DePuey, E.Gordon</au><au>Guertler-Krawczynska, E.</au><au>Perkins, John V.</au><au>Robbins, Wendy L.</au><au>Whelchel, John D.</au><au>Clements, Stephen D.</au><aucorp>Emory Univ. School of Medicine, Atlanta, GA (USA)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Alterations in myocardial thallium-201 distribution in patients with chronic systemic hypertension undergoing single-photon emission computed tomography</atitle><jtitle>Am. J. Cardiol.; (United States)</jtitle><addtitle>Am J Cardiol</addtitle><date>1988-08-01</date><risdate>1988</risdate><volume>62</volume><issue>4</issue><spage>234</spage><epage>238</epage><pages>234-238</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>To characterize thallium-201 distribution in singlephoton emission computed tomography (SPECT) cardiac images and polar bullseye maps, 100 patients with chronic systemic hypertension due to end-stage renal disease were studied and the results compared with those in 35 normotensive control subjects. Thallium-201 SPECT was performed after exercise in all control subjects and 70 hypertensive patients, and after intravenous dipyridamole in 30 patients. A frequent finding in hypertensive patients was a fixed decrease in the normal lateral-to-septal count density ratio in immediate thallium-201 SPECT images (1.02 ± 0.10 vs 1.17 ± 0.08 in control subjects, p < 0.00001) and in 3-hour delayed images (1.02 ± 0.11 vs 1.11 ± 0.08 in control subjects, p < 0.00001). No significant difference in count density ratio was present in patients undergoing treadmill versus diypridamole intervention. In 35 patients the count density ratio was >2.0 standard deviations below the normal mean, creating the false impression of a fixed lateral defect (i.e., myocardial infarction).
In 12 patients, myocardial wall thickness was measured at end-diastole by 2-dimensional echocardiography. Wall thickness was increased (>11 mm) in all patients. The mean lateral-to-septal wall thickness ratio was 1.08 ± 1.11; in no patient was the ratio < 0.76 to indicate selective septal hypertrophy. The lateral-to-septal wall thickness and lateral-to-septal thallium-201 count density ratios correlated poorly (r = 0.43).
It is concluded that in hypertensive patients with diffuse myocardial hypertrophy there is a decrease in thallium-201 count density ratio in SPECT images, frequently creating apparent lateral wall fixed defects and mimicking myocardial infarction.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>2969670</pmid><doi>10.1016/0002-9149(88)90218-4</doi><tpages>5</tpages></addata></record> |
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| subjects | Arterial hypertension. Arterial hypotension BETA DECAY RADIOISOTOPES Biological and medical sciences Blood and lymphatic vessels BODY Cardiology. Vascular system Cardiomegaly - diagnostic imaging CARDIOVASCULAR AGENTS CARDIOVASCULAR DISEASES CARDIOVASCULAR SYSTEM Clinical manifestations. Epidemiology. Investigative techniques. Etiology COMPUTERIZED TOMOGRAPHY DAYS LIVING RADIOISOTOPES DIAGNOSIS Diagnosis, Differential DIAGNOSTIC TECHNIQUES DIAGRAMS Dipyridamole DISEASES DRUGS Echocardiography ELECTROCARDIOGRAMS ELECTRON CAPTURE RADIOISOTOPES EMISSION COMPUTED TOMOGRAPHY EXERCISE Female HEART Heart - diagnostic imaging HEAVY NUCLEI Humans HYPERTENSION Hypertension - diagnostic imaging ISOMERIC TRANSITION ISOTOPES ISOTOPES Male Medical sciences MUSCLES MYOCARDIAL INFARCTION Myocardial Infarction - diagnostic imaging MYOCARDIUM Myocardium - metabolism NUCLEI ODD-EVEN NUCLEI ORGANS PATIENTS Physical Exertion RADIOISOTOPES RADIOLOGY AND NUCLEAR MEDICINE Risk Factors SECONDS LIVING RADIOISOTOPES SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY SYMPTOMS THALLIUM 201 THALLIUM ISOTOPES Thallium Radioisotopes TOMOGRAPHY Tomography, Emission-Computed UPTAKE VASCULAR DISEASES 550601 -- Medicine-- Unsealed Radionuclides in Diagnostics VASODILATORS |
| title | Alterations in myocardial thallium-201 distribution in patients with chronic systemic hypertension undergoing single-photon emission computed tomography |
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