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European Heart Journal 1992 13(9):1189-1194;
Copyright © 1992 by the European Society of Cardiology.
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© 1992 The European Society of Cardiology

Improvement in the efficacy of exercise first-pass radionuclide angiocardiography in detecting coronary artery disease and the effect of patient age

P. R. FRANKEN, A. VERVAET, R. RANQUIN, S. LIEBER, P. VAN DEN HEUVEL, F. VAN DEN BRANDEN, A. A. DOBBELEIR and J. VANDEVIVERE

Division of Nuclear Medicine and Cardiology, Middelheim General Hospital Antwerp, Belgium

Received 12 November 1990; revised 6 August 1991; .

Correspondence P. R. Franken, MD, Division of Nuclear Medicine, Academic Hospital V.U.B., Laarbeeklaan 101, B-1090, Brussels, Belgium

Abstract

The most widely used criterion of normality during exercise radionuclide angiocardiography (a five EF units increase in left ventricular ejection fraction from rest to exercise) has been established in young, healthy volunteers resulting in a relatively low specificity when applied to older, less fit patients or in women. In a group of 57 patients ranging in age from 22 to 79 years with a low likelihood of coronary artery disease, the age of the patient was the only independent variable predicting left ventricular ejection fraction change during exercise. The efficacy of a new age-based criterion for the diagnosis of coronary artery disease was then evaluated in 115 patients with chest pain undergoing both exercise first-pass radionuclide angiocardiography and coronary arteriography. Compared to the classic five EF unit criterion, the age-based criterion had a higher specificity (73·2% vs 34·1% P< 0·001) without significant loss in sensitivity (85·1% vs 92·6%; P= NS).

Key Words: Exercise first-pass radionuclide angiocardiography • normal left ventricular function • influence of age • diagnosis of coronary artery disease


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