Isoproterenol stress thallium scintigraphy for detecting coronary artery disease

The value of exercise thallium scintigraphy in detecting coronary artery disease is well established. However, there are at times situations in which the exercise test cannot be readily used. Isoproterenol (ISP) stress ECG (ISP-ECG) is reportedly a useful method in diagnosing coronary artery disease. In the present study, we assessed the diagnostic value of ISP thallium scintigraphy, comparing it with those of ISP-ECG and exercise thallium scintigraphy. The study population consisted of 24 patients who had histories of chest pain without previous myocardial infarction. ISP was given at increasing doses of 0.02, 0.04, 0.08 micrograms/kg/min at 3-minute intervals, and was terminated for any of the following reasons: angina, significant arrhythmia, significant ST segment depression (greater than or equal to 0.1 mV) or target heart rate. Thallium scintigrams were obtained immediately after terminating ISP infusion, and after a 3-hour delay, redistribution scans were obtained. Scintigrams were considered positive when a reversible defect was present. In nine patients who underwent exercise tests, exercise thallium scintigraphy was also performed. After the stress tests, coronary angiography was performed. According to the presence or absence of significant coronary artery stenosis (greater than or equal to 75%), all subjects were divided into two groups: coronary artery disease (CAD) group (n = 12) and so-called normal coronary (NC) group (n = 12). 1. Among 12 patients in the CAD group, ISP induced anginal pain in six (50%), and ISP-ECG and ISP thallium scintigraphy were positive in 10 (83%) and in 11 (92%), compared with four (33%), four (33%) and two (17%) in the NC group.(ABSTRACT TRUNCATED AT 250 WORDS)