Potassium-43 myocardial perfusion scanning for the noninvasive evaluation of patients with false-positive exercise tests

Twelve patients with false-positive ECG exercise tests presented with ischemic ECG responses (greater than one mm ST segment depression) during graded maximal treadmill exercise testing in the absence of exercise-induced chest pain or clinical coronary heart disease. Coronary arteriography, left ven...

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Veröffentlicht in:Circulation (New York, N.Y.) N.Y.), 1973-12, Vol.48 (6), p.1234-1241
Hauptverfasser: Zaret, B L, Stenson, R E, Martin, N D, Strauss, H W, Wells, Jr, H P, McGowan, R L, Flamm, Jr, M D
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Sprache:eng
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Zusammenfassung:Twelve patients with false-positive ECG exercise tests presented with ischemic ECG responses (greater than one mm ST segment depression) during graded maximal treadmill exercise testing in the absence of exercise-induced chest pain or clinical coronary heart disease. Coronary arteriography, left ventriculography and hemodynamic evaluation revealed no significant abnormality in these patients. Transmyocardial lactate analysis during atrial pacing revealed a normal extraction (mean 21%) during pacing stress in five patients. Nine of 12 patients were evaluated with exercise potassium-43 myocardial perfusion imaging whereby the radioactive tracer was administered intravenously during exercise at a time when abnormal ECG changes were present. Myocardial images in these nine patients all showed a normal homogeneous pattern of radioisotope distribution. These results are in direct contrast to findings in patients with coronary heart disease in whom reproducibly demonstrable abnormal regions of decreased potassium-43 accumulation have been noted in myocardial images obtained following injection of the radioactive tracer during exercise. Potassium-43 exercise myocardial perfusion scanning thus appears to be an accurate noninvasive method of assessing patients with suspected false-positive exercise tests and provides a means of increasing the specificity of exercise testing.
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.48.6.1234