201Tl myocardial perfusion SPET: adenosine alone or combined with dynamic exercise

201Tl myocardial perfusion single photon emission tomography (SPET) with pharmacological coronary vasodilatation using adenosine is now often used in the investigation of a patient with ischaemic heart disease (IHD). In this study, we present data from two groups of patients. Group A (n = 40) experienced 201Tl SPET with adenosine only as the pharmacological stress test, using an infusion rate of 140 micrograms kg-1 min-1. Group B patients (n = 50) had the same test combined with low-level dynamic exercise. The side effects were noted for both groups and 201Tl SPET studies were acquired for stress and redistribution images. There was a lesser degree of non-cardiac side effects in patients of group B. There was a significant difference in the haemodynamic parameters between the two groups. There was no significant difference in overall sensitivity (87% versus 90%) and specificity (84% versus 88%) in the detection of IHD between the two groups. In conclusion, addition of low-level dynamic exercise with adenosine is to be preferred to adenosine infusion alone, as this protocol is better tolerated and may enhance the detection of right coronary artery disease (sensitivity = 82% versus 90%, n.s.).