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First-third ejection fraction at rest compared with exercise radionuclide angiography in assessing patients with
Insights
First-third ejection fraction (EF) by first-pass radionuclide angiography at rest is a sensitive method for identifying coronary artery disease. This method may be as effective as exercise-induced EF response in diagnosing patients with this condition.
Area of Science:
- Cardiology
- Nuclear Cardiology
- Diagnostic Imaging
Background:
- Coronary artery disease (CAD) diagnosis relies on accurate assessment of cardiac function.
- Ejection fraction (EF) is a key indicator of left ventricular systolic function.
- Traditional methods for EF assessment may have limitations in sensitivity for early CAD detection.
Purpose of the Study:
- To compare the diagnostic sensitivity of resting first-third ejection fraction (1/3 EF) using first-pass radionuclide angiography (FP-RNGA) versus exercise-induced EF response in patients with suspected coronary artery disease.
- To evaluate the utility of 1/3 EF as a standalone diagnostic tool for CAD.
Main Methods:
- Evaluated 22 normal individuals and 40 patients with suspected CAD.
- Measured resting ejection fraction during the first-third of systole (1/3 EF) using FP-RNGA, averaging 3-5 beats.
- Assessed exercise ejection fraction response using gated cardiac imaging.
Main Results:
- Resting 1/3 EF was depressed in 98% of patients with CAD.
- Abnormal EF response to exercise was observed in 88% of CAD patients.
- Resting EF was depressed in 30% of CAD patients.
Conclusions:
- Resting 1/3 EF measured by FP-RNGA demonstrates high sensitivity in identifying patients with coronary artery disease.
- The 1/3 EF method shows comparable or potentially superior sensitivity to exercise EF response for CAD detection.
- Resting 1/3 EF is a valuable and sensitive tool for diagnosing coronary artery disease.
Abstract:
To compare two methods of evaluating patients with coronary artery disease, the authors assessed the ejection fraction (EF) during the first-third (1/3) of systole by first-pass radionuclide angiography and the EF response to exercise in 22 normal individuals and 40 patients. The 1/3 EF was calculated by averaging 3--5 beats on the time--activity curve. Exercise EFs were obtained by gated cardiac imaging. The results are shown below, including the per cent change in EF with exercise (% EF). (Formula: see text) p less than 0.05 vs. normals; p less than 0.001 vs. normals; all results are +/- SD. Thirty per cent of patients had a depressed EF, 98% had a depressed 1/3 EF, and 88% had an abnormal EF response to exercise. It is concluded that the 1/3 EF by first-pass radionuclide angiography at rest may be at least as sensitive in identifying patients with coronary artery disease as the EF response to exercise.