Potassium-43 Myocardial Perfusion Scanning for the Noninvasive Evaluation of Patients with False-Positive Exercise Tests

Author:

ZARET BARRY L.1,STENSON ROBERT E.1,MARTIN NEIL D.1,STRAUSS H. WILLIAM1,WELLS HARRY P.1,MCGOWAN RONALD L.1,FLAMM M. D.1

Affiliation:

1. From the Cardiology and Nuclear Medicine Sections, Department of Medicine, David Grant USAF Medical Center, Travis AFB, California.

Abstract

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.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

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