Skip to main content
NCBI home page
British Heart Journal logoLink to British Heart Journal
. 1982 Sep;48(3):260–264. doi: 10.1136/hrt.48.3.260

Reversible ischaemia of right ventricle detected by exercise thallium-201 scintigraphy.

A Lahiri, G P Carboni, J W Crawley, E B Raftery
PMCID: PMC481239  PMID: 7104119

Abstract

Exercise and redistribution thallium-201 imaging is commonly used for the detection and evaluation of left ventricular ischaemia and infarction. The right ventricle is frequently visualised after stress and sometimes on redistribution images. The visualisation of the right ventricle at rest is thought to be abnormal and is suggestive of pressure or volume overload of the right ventricle, either a result of pulmonary hypertension or secondary to left ventricular dysfunction. Using stress and delayed 201Tl imaging we have shown reversible left and right ventricular ischaemia and fixed left ventricular perfusion defects in two patients with multivessel coronary artery disease and left ventricular dyskinesia caused by prior myocardial infarction. Judging by the rarity of this finding as well as taking into consideration 201Tl kinetics, it is suggested that reversible right ventricular ischaemia after exercise may only be detected in patients with coronary artery disease who have severely compromised ventricular function. This finding may have therapeutic and prognostic significance.

Full text

PDF
260

Images in this article

261Image
on p.261
262Image
on p.262

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bingham J. B., McKusick K. A., Strauss H. W., Boucher C. A., Pohost G. M. Influence of coronary artery disease on pulmonary uptake of thallium-201. Am J Cardiol. 1980 Nov;46(5):821–826. doi: 10.1016/0002-9149(80)90434-8. [DOI] [PubMed] [Google Scholar]
  2. Brachman M. B., Rozanski A., Charuzi Y., Maddahi J., Waxman A. D., Berman D. S. Thallium-201 stress redistribution abnormalities of the right ventricle: a manifestation of proximal right coronary artery stenosis. Am Heart J. 1981 Mar;101(3):288–291. doi: 10.1016/0002-8703(81)90192-7. [DOI] [PubMed] [Google Scholar]
  3. Candell-Riera J., Figueras J., Valle V., Alvarez A., Gutierrez L., Cortadellas J., Cinca J., Salas A., Rius J. Right ventricular infarction: relationships between ST segment elevation in V4R and hemodynamic, scintigraphic, and echocardiographic findings in patients with acute inferior myocardial infarction. Am Heart J. 1981 Mar;101(3):281–287. doi: 10.1016/0002-8703(81)90191-5. [DOI] [PubMed] [Google Scholar]
  4. Cohen H. A., Baird M. G., Rouleau J. R., Fuhrmann C. F., Bailey I. K., Summer W. R., Strauss H. W., Pitt B. Thallium 201 myocardial imaging in patients with pulmonary hypertension. Circulation. 1976 Nov;54(5):790–795. doi: 10.1161/01.cir.54.5.790. [DOI] [PubMed] [Google Scholar]
  5. Isner J. M., Roberts W. C. Right ventricular infarction complicating left ventricular infarction secondary to coronary heart disease. Frequency, location, associated findings and significance from analysis of 236 necropsy patients with acute or healed myocardial infarction. Am J Cardiol. 1978 Dec;42(6):885–894. doi: 10.1016/0002-9149(78)90672-0. [DOI] [PubMed] [Google Scholar]
  6. Khaja F., Alam M., Goldstein S., Anbe D. T., Marks D. S. Diagnostic value of visualization of the right ventricle using thallium-201 myocardial imaging. Circulation. 1979 Jan;59(1):182–188. doi: 10.1161/01.cir.59.1.182. [DOI] [PubMed] [Google Scholar]
  7. Kushner F. G., Okada R. D., Kirshenbaum H. D., Boucher C. A., Strauss H. W., Pohost G. M. Lung thallium-201 uptake after stress testing in patients with coronary artery disease. Circulation. 1981 Feb;63(2):341–347. doi: 10.1161/01.cir.63.2.341. [DOI] [PubMed] [Google Scholar]
  8. Lahiri A., Balasubramanian V., Millar Craig M. W., Crawley J., Raftery E. B. Exercise-induced ST segment elevation. Electrocardiographic, angiographic, and scintigraphic evaluation. Br Heart J. 1980 May;43(5):582–588. doi: 10.1136/hrt.43.5.582. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Lahiri A., Spencer J., Crawley J. W., Raftery E. B. Pulmonary uptake of thallium 201 in acute pulmonary oedema. Br J Radiol. 1982 Jun;55(654):460–462. doi: 10.1259/0007-1285-55-654-460. [DOI] [PubMed] [Google Scholar]
  10. Lahiri A., Subramanian B., Millar-Craig M., Crawley J., Raftery E. B. Exercise-induced S-T segment elevation in variant angina. Am J Cardiol. 1980 Apr;45(4):887–894. doi: 10.1016/0002-9149(80)90136-8. [DOI] [PubMed] [Google Scholar]
  11. Maddox D. E., Wynne J., Uren R., Parker J. A., Idoine J., Siegel L. C., Neill J. M., Cohn P. F., Holman B. L. Regional ejection fraction: a quantative radionuclide index of regional left ventricular performance. Circulation. 1979 May;59(5):1001–1009. doi: 10.1161/01.cir.59.5.1001. [DOI] [PubMed] [Google Scholar]
  12. Pohost G. M., Zir L. M., Moore R. H., McKusick K. A., Guiney T. E., Beller G. A. Differentiation of transiently ischemic from infarcted myocardium by serial imaging after a single dose of thallium-201. Circulation. 1977 Feb;55(2):294–302. doi: 10.1161/01.cir.55.2.294. [DOI] [PubMed] [Google Scholar]
  13. Rigo P., Becker L. C., Griffith L. S., Alderson P. O., Bailey I. K., Pitt B., Burow R. D., Wagner H. N., Jr Influence of coronary collateral vessels on the results of thallium-201 myocardial stress imaging. Am J Cardiol. 1979 Sep;44(3):452–458. doi: 10.1016/0002-9149(79)90396-5. [DOI] [PubMed] [Google Scholar]
  14. Rosenblatt A., Lowenstein J. M., Kerth W., Handmaker H. Post-exercise thallium-201 myocardial scanning: a clinical appraisal. Am Heart J. 1977 Oct;94(4):463–470. doi: 10.1016/s0002-8703(77)80041-0. [DOI] [PubMed] [Google Scholar]
  15. Sharpe D. N., Botvinick E. H., Shames D. M., Schiller N. B., Massie B. M., Chatterjee K., Parmley W. W. The noninvasive diagnosis of right ventricular infarction. Circulation. 1978 Mar;57(3):483–490. doi: 10.1161/01.cir.57.3.483. [DOI] [PubMed] [Google Scholar]
  16. Slutsky R., Hooper W., Gerber K., Battler A., Froelicher V., Ashburn W., Karliner J. Assessment of right ventricular function at rest and during exercise in patients with coronary heart disease: a new approach using equilibrium radionuclide angiography. Am J Cardiol. 1980 Jan;45(1):63–71. doi: 10.1016/0002-9149(80)90221-0. [DOI] [PubMed] [Google Scholar]
  17. Ter-Pogossian M. M., Klein M. S., Markham J., Roberts R., Sobel B. E. Regional assessment of myocardial metabolic integrity in vivo by positron-emission tomography with 11C-labeled palmitate. Circulation. 1980 Feb;61(2):242–255. doi: 10.1161/01.cir.61.2.242. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES