The variable extent of jeopardized myocardium in patients with single vessel coronary artery disease: quantification by thallium-201 single photon emission computed tomography

Department of Internal Medicine, Methodist Hospital, Baylor College of Medicine, Houston, Texas 77030.

To assess the extent of jeopardized myocardium in patients with single vessel coronary artery disease of variable severity and location, quantitative exercise thallium-201 single photon emission computed tomography was performed in 158 consecutive patients with angiographically proved single vessel coronary artery disease. The extent of abnormal left ventricular perfusion was quantified from computer-generated polar maps of three-dimensional myocardial radioactivity. Patients with only a moderate (51% to 69%) stenosis tended to have a small perfusion defect irrespective of the coronary artery involved. Whereas a perfusion defect measuring greater than or equal to 10% of the left ventricle was found in 78% of patients with no prior infarction and severe (greater than or equal to 70%) stenosis, this was observed in only 24% of patients with moderate stenosis. Perfusion defect size increased with increasing severity of stenosis for the entire group without infarction and for those with left anterior descending, right and circumflex coronary artery stenosis. However, the correlation between stenosis severity and perfusion defect size was at best only modest (r = 0.38, p = 0.0001). The left anterior descending artery was shown to be the most important of the three coronary arteries for providing left ventricular perfusion. Proximal stenosis of this artery produced a perfusion defect approximately twice as large as that found in patients with a proximal right or circumflex artery stenosis. However, marked heterogeneity in perfusion defect size existed among all three vessels despite comparable stenosis severity. This was most apparent for the left anterior descending coronary artery, where mid vessel stenosis commonly produced a perfusion defect similar in size to that found in proximally stenosed vessels.(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				R. Sciagra, B. Sotgia, N. Boni, and A. Pupi Assessment of the Influence of Atrial Fibrillation on Gated SPECT Perfusion Data by Comparison with Simultaneously Acquired Nongated SPECT Data J. Nucl. Med., August 1, 2008; 49(8): 1283 - 1287. [Abstract] [Full Text] [PDF]

				M. Boodhwani, F. D. Rubens, F. W. Sellke, T. G. Mesana, and M. Ruel Mortality and myocardial infarction following surgical versus percutaneous revascularization of isolated left anterior descending artery disease: a meta-analysis Eur. J. Cardiothorac. Surg., January 1, 2006; 29(1): 65 - 70. [Abstract] [Full Text] [PDF]

				V. J. Amodeo, H. W. Donias, G. D'Ancona, E. L. Hoover, and H. L. Karamanoukian The Hybrid Approach to Coronary Artery Revascularization: Minimally Invasive Direct Coronary Artery Bypass with Percutaneous Coronary Intervention Angiology, November 1, 2002; 53(6): 665 - 669. [Abstract] [PDF]

				F Piscione, P Perrone-Filardi, G De Luca, M Prastaro, C Indolfi, P Golino, S Dellegrottaglie, and M Chiariello Low dose dobutamine echocardiography for predicting functional recovery after coronary revascularisation Heart, December 1, 2001; 86(6): 679 - 686. [Abstract] [Full Text] [PDF]

				J. H. O’Keefe Jr, T. R. Kreamer, P. G. Jones, J. L. Vacek, M. E. Gorton, G. F. Muehlebach, B. D. Rutherford, and B. D. McCallister Isolated Left Anterior Descending Coronary Artery Disease : Percutaneous Transluminal Coronary Angioplasty Versus Stenting Versus Left Internal Mammary Artery Bypass Grafting Circulation, November 9, 1999; 100(90002): II-114 - 118. [Abstract] [Full Text] [PDF]

				M. Zenati, H. A. Cohen, and B. P. Griffith ALTERNATIVE APPROACH TO MULTIVESSEL CORONARY DISEASE WITH INTEGRATED CORONARY REVASCULARIZATION J. Thorac. Cardiovasc. Surg., March 1, 1999; 117(3): 439 - 446. [Abstract] [Full Text] [PDF]

				F. Versaci, A. Gaspardone, F. Tomai, F. Crea, L. Chiariello, and P. A. Gioffre A Comparison of Coronary-Artery Stenting with Angioplasty for Isolated Stenosis of the Proximal Left Anterior Descending Coronary Artery N. Engl. J. Med., March 20, 1997; 336(12): 817 - 822. [Abstract] [Full Text] [PDF]

				H. Matsuo, S. Watanabe, T. Kadosaki, T. Yamaki, S. Tanaka, S. Miyata, T. Segawa, Y. Matsuno, M. Tomita, and H. Fujiwara Validation of Collateral Fractional Flow Reserve by Myocardial Perfusion Imaging Circulation, March 5, 2002; 105(9): 1060 - 1065. [Abstract] [Full Text] [PDF]