The role of nuclear cardiology in hypertension

Sd, Pringle; Fg, Dunn; Ar, Lorimer; Jh, McKillop

doi:10.1097/00006231-199401000-00002

Cited by 9 publications

(2 citation statements)

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“…Hypertension is one of the most common risk factors for coronary artery disease encountered in patients undergoing exercise stress testing 4. Although exercise myocardial perfusion scintigraphy has been shown to be more accurate than exercise electrocardiography for the diagnosis of coronary artery disease,5 myocardial perfusion abnormalities may occur in hypertensive patients without significant epicardial coronary artery disease 6-8. Such abnormalities may not necessarily represent a false positive diagnosis of myocardial ischaemia as they may represent the sequelae of microvascular disease, impaired vasodilator reserve, and increased myocardial oxygen demand in a certain subset of hypertensive patients 6-11.…”

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confidence: 99%

Impact of hypertension on the accuracy of exercise stress myocardial perfusion imaging for the diagnosis of coronary artery disease

Elhendy

Domburg

Sozzi

et al. 2001

Heart

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Aim-To compare the accuracy of exercise stress myocardial perfusion single photon emission computed tomography (SPECT) imaging for the diagnosis of coronary artery disease in patients with and without hypertension. Methods-A symptom limited bicycle exercise stress test in conjunction with 99m technetium sestamibi or tetrofosmin SPECT imaging was performed in 332 patients (mean (SD) age, 57 (10) years; 257 men, 75 women) without previous myocardial infarction who underwent coronary angiography. Of these, 137 (41%) had hypertension. Rest SPECT images were acquired 24 hours after the stress test. An abnormal scan was defined as one with reversible or fixed perfusion defects. Results-In hypertensive patients, myocardial perfusion abnormalities were detected in 79 of 102 patients with significant coronary artery disease and in nine of 35 patients without. In normotensive patients, myocardial perfusion abnormalities were detected in 104 of 138 patients with significant coronary artery disease and in 16 of 57 patients without. There were no diVerences between normotensive and hypertensive patients in sensitivity (77% (95% confidence interval (CI) 69% to 86%) v 75% (95% CI 68% to 83%)), specificity (74% (95% CI 60% to 89%) v 72% (95% CI 60% to 84%)), and accuracy (77% (95% CI 70% to 84%) v 74% (95% CI 68% to 80%)) of exercise SPECT for diagnosing coronary artery disease. The accuracy of SPECT was greater than electrocardiography, both in hypertensive patients (p = 0.005) and in normotensive patients (p = 0.0001). For the detection of coronary artery disease in individual vessels, sensitivity was 58% (95% CI 51% to 65%) v 57% (95% CI 51% to 64%), specificity was 86% (95% CI 82% to 90%) v 85% (95% CI 81% to 89%), and accuracy was 74% (95% CI 70% to 78%) v 74% (95% CI 70% to 78%) in patients with and without hypertension (NS). Conclusions-In the usual clinical setting, the value of exercise myocardial perfusion scintigraphy for diagnosing coronary artery disease is not degraded by the presence of hypertension. (Heart 2001;85:655-661)

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Impact of hypertension on the accuracy of exercise stress myocardial perfusion imaging for the diagnosis of coronary artery disease

Elhendy

Domburg

Sozzi

et al. 2001

Heart

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“…Thallium-201 ( 201 Tl) und Technetium-99m-( 99m Tc-)MIBI werden am häufigsten zur semiquantitativen Beurteilung myokardialer Perfusionsdefekte verwendet. Bei Patienten mit Hypertonie und Brustschmerzen oder Ischämiezeichen im EKG ohne vorausgegangenen Myokardinfarkt schließt ein negatives Dipyridamol-201 Tl-Myokardszintigramm eine signifikante Obstruktion epikardialer Koronargefäße im Rahmen einer koexistenten koronaren Herzerkrankung mit arterieller Hypertonie aus [2,4,40]. Eine invasiv bestimmte Einschränkung der Koronarreserve bei Patienten mit hypertensiv bedingter Mikroangiopathie kann durch eine pathologische Myokardszintigraphie frühzeitig anzeigt werden [18,19].…”

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Hypertensive mikrovaskul�re Erkrankung

Schannwell

Steiner²,

Strauer

2005

Herz

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Arterial hypertension is a major cardiovascular risk factor and leads to vascular as well as to myocardial manifestations. Particularly hypertensive microvascular disease is of great importance. Major clinical manifestations of hypertensive heart disease are symptoms of coronary insufficiency with typical angina pectoris, but also heart failure (systolic or diastolic dysfunction) and arrhythmia. Different non-invasive and invasive procedures are available for screening. For ultimate quantitative assessment of the coronary reserve, invasive procedures are still required. Beside lowering blood pressure primary therapeutic target is to reverse cardiac manifestations of arterial hypertension using specific therapeutic algorithms.

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What is the current status of quantification and nuclear medicine in cardiology?

Hör

1996

Eur J Nucl Med

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The role of nuclear cardiology in hypertension

Cited by 9 publications

References 0 publications

Impact of hypertension on the accuracy of exercise stress myocardial perfusion imaging for the diagnosis of coronary artery disease

Impact of hypertension on the accuracy of exercise stress myocardial perfusion imaging for the diagnosis of coronary artery disease

Hypertensive mikrovaskul�re Erkrankung

What is the current status of quantification and nuclear medicine in cardiology?

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