Related Experiment Videos
Exercise echocardiography after stabilization of unstable angina: correlation with exercise thallium-201 single
A M Amanullah1, K Lindvall, S Bevegård
1Department of Cardiology, Karolinska Institute, South Hospital, Stockholm, Sweden.
Insights
Predischarge exercise echocardiography is a valuable diagnostic tool for unstable angina patients, showing 80% agreement with thallium-201 single-photon emission computed tomography (TI-SPECT) in detecting myocardial ischemia.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- Unstable angina requires accurate risk stratification before discharge.
- Noninvasive diagnostic methods are crucial for assessing myocardial ischemia.
Purpose of the Study:
- To evaluate the diagnostic utility of predischarge exercise echocardiography.
- To correlate exercise echocardiography findings with TI-SPECT in unstable angina patients.
Main Methods:
- Exercise echocardiography was performed in 35 unstable angina patients.
- TI-SPECT was conducted three days post-exercise echocardiography.
- Comparison of results between the two imaging modalities.
Main Results:
- Exercise echocardiography was positive in 21 patients; TI-SPECT in 24.
- Concordant results were observed in 28 of 35 patients (80% agreement).
- High correlation found in detecting and localizing ischemia when both tests were positive.
Conclusions:
- Exercise echocardiography is a valuable addition to predischarge testing for unstable angina.
- It demonstrates good correlation with TI-SPECT in diagnosing myocardial ischemia.
- This technique aids in noninvasive diagnosis and risk assessment.
Abstract:
The diagnostic usefulness of predischarge exercise echocardiography in 35 patients with unstable angina who responded to medical therapy was correlated with exercise thallium-201 single photon emission computed tomography (TI-SPECT) performed, on the average, three days after the exercise echocardiography. None of the patients had myocardial infarction prior to hospitalization or before TI-SPECT and none had left bundle-branch block on their rest electrocardiogram (ECG). Exercise echocardiography was positive in 21 patients and TI-SPECT in 24. The results of the two techniques were concordant in 28 of 35 patients (agreement = 80%, k = 0.57 +/- 0.14, p less than 0.001). Wall-by-wall comparison of the distribution of exercise-induced wall motion abnormalities with reversible thallium defects showed complete or partial correlation in all of 19 patients in whom both the tests were positive. A positive exercise ECG and positive exercise echocardiography identified 11 of 11 patients with angiographically verified significant coronary artery disease (CAD) and 11 of 12 patients (92%) with positive TI-SPECT. Thus, exercise echocardiography is a valuable addition to routine predischarge exercise test in the noninvasive diagnosis of myocardial ischemia and shows a good correlation with TI-SPECT in detecting and localizing ischemia in patients with unstable angina stabilized on medical therapy.