Thallium-201 myocardial perfusion aspect: adenosine alone and adenosine combined with exercise

ABSTRACT

To study whether combination of pharmacological stress test using Adenosine infusion with dynamic exercise of 25 watts, enhances the detection of Coronary Artery Disease. [CAD] Design: Prospective study involving 660 consecutive patients referred for myocardial perfusion SPECT. Setting: Punjab Institute of Cardiology, Lahore. Subjects: Of the referred 660 patients the first 160 patients under-went a pharmacological stress test using Adenosine only [Group A]. In the next 500 patients [Group B] adenosine infusion was combined with dynamic exercise of 25 watts for six minutes. Coronary Angiography results were available in 90 patients, 40 in Group A and 50 in Group B. Segmental analysis of thallium-201 SPECT revealed an overall sensitivity and specificity was similar in both groups [87% vs 90% and 84% vs 88% respectively]. For RCA lesions the sensitivity was 82% for Group A and 90% for Group B. Conclusions: Use of dynamic exercise in addition to Adenosine decreases the drug related side effects and it appears to be more sensitive in detection of RCA lesions