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      Persistent Thallium-201 Defect: Can Clinical, Electrocardiographic and Exercise Hemodynamic Variables Predict Defect Normalization with Reinjection?

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          Abstract

          This study was designed to assess the contribution of clinical, electrocardiographic and exercise hemodynamic variables to the prediction of normalization on resting reinjection scintigraphy of persistent thallium-201 (<sup>201</sup>Tl) myocardial perfusion defects seen with exercise and 2- to 4-hour delayed (redistribution) imaging. To evaluate this contribution, we studied 159 consecutive patients with persistent <sup>201</sup>Tl myocardial perfusion defects on routine exercise and 2- to 4-hour-delayed scintigrams at the University of Rochester Medical Center who were classified as having moderate or greater ischemic normalization (group 1, n = 76) or minimal to no ischemic normalization (group 2, n = 83) by reinjection scintigraphy. Multiple logistic regression analysis with backward elimination was used to model the effects of clinical, electrocardiographic and exercise hemodynamic data on the odds ratio of a normalized defect. No difference was observed in the two groups with regard to gender, angina on exertion, rate-pressure product, exercise duration, resting or exertional ischemic ST changes on electrocardiogram, presence of Q waves or left ventricular hypertrophy on baseline electrocardiogram, or total number of stress thallium defects (2.8 ± 1.5 segments). No single variable or combination of variables discriminated between groups 1 and 2 by logistic regression analysis. We conclude that defect normalization seen on resting <sup>201</sup>Tl myocardial perfusion scintigraphy is prevalent in patients with persistent defects on routine exercise and delayed myocardial perfusion scintigraphy, and was not predictable from available clinical, electrocardiographic and exercise hemodynamic variables.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1996
          1996
          19 November 2008
          : 87
          : 3
          : 235-239
          Affiliations
          Departments of aMedicine (Cardiology Unit), bRadiology (Division of Nuclear Medicine) and cBiostatistics, University of Rochester, School of Medicine and Dentistry, Rochester, N.Y., USA
          Article
          177093 Cardiology 1996;87:235–239
          10.1159/000177093
          8725320
          © 1996 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 5
          Categories
          Noninvasive and Diagnostic Cardiology

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