@article{059ba9fc2b844693a36aa652765ee506,
title = "Diagnostic accuracy of exercise thallium-201 scintigraphy in men with asymptomatic essential hypertension",
abstract = "Coronary artery disease is responsible for much of the morbidity and mortality in patients with essential hypertension, and these complications have proven to be relatively resistant to antihypertensive therapy. However, the diagnosis of coronary disease in the hypertensive population has been considered problematic. In the present study, 30 asymptomatic patients with mild to moderate hypertension with positive exercise electrocardiograms (ECG) or stress thallium-201 scintigrams underwent coronary angiography to determine the accuracy of these tests for coronary artery disease. The exercise ECG was positive in 25 subjects, of whom 15 had significant coronary lesions and 10 did not. Thallium-201 scintigraphy proved more accurate: 17 of 18 patients with reversible abnormalities had significant obstructive coronary disease anatomically corresponding to the defect, one patient with a fixed defect had normal coronary arteries and was found to have an idiopathic cardiomyopathy, and 9 of 11 without defects had no significant lesions. The results were similar in populations with and without echocardiographic criteria for left ventricular hypertrophy. These findings indicate that despite previous suggestions to the contrary, thallium-201 scintigraphy can accurately diagnose coronary artery disease in most patients with asymptomatic essential hypertension, and that most asymptomatic hypertensive patients with physiologic evidence of myocardial ischemia have associated coronary artery disease.",
keywords = "201T1 scintigraphy, Coronary artery disease, Exercise testing, Hypertension, Left ventricular hypertrophy",
author = "Chin, {William L.} and Brian O'kelly and Tuhau, {Julio F.} and Jadwiga Szlachcic and David Brown and Wisneski, {Judith A.} and Susan Ammon and Massie, {Barry M.}",
note = "Funding Information: Received November 26, 1991. Accepted March 16, 1992. oronary artery disease and essential hyper-Institute,University ofCalifornia, andtheCardiology Service, VeterFromthe Department of MedicineandCardiovascular Research tension frequently coexist, and ischemic heart ansAffairsMedical Center, SanFrancisco, California. disease is the major cause of morbidity and This work is supported in part by the Veterans Affairs Research C mortality in the hypertensive population. Lung,andBloodInstitute, NationalInstitutes ofHealth, Bethesda, ServiceandgrantsNo. HL-25847and HL-07192,National Heart, However, the diagnosis of coronary artery disease in Maryland.Dr.O'KellywasafellowsupportedbytheAlberta Heritage this population has been considered problematic.1 Hy Foundation for Research, Alberta, Canada. pertension is often associated with repolarization abnor-theAmericanCollege ofCardiology,March 3to7, 1991,inAtlanta, This studywas presented at the40th annualscientificsession of malities on the resting electrocardiogram, and a number Georgia. of studies have indicated that ST segment changes on Dr. Chin is now at Kaiser Hospital, Fontana, California. Dr. O'Kelly the exercise electrocardiogram are not specific for coro-TubauisnowatLosAngelesCountyHospital,UniversityofSouthern isnowatTorontoWesternHospital,Toronto,Ontario,Canada. Dr. nary artery disease.2{"}5 Several studies have also indi-California SchoolofMedicine, LosAngeles, California. Dr. Szlachcic cated that exercise201T1 scintigraphy may yield frequent isnowatRanchoLosAmigosHospital,UniversityofSouthernCalifor falsepositiveresultsforcoronarydisease,1,6'7althoughit niaSchool ofMedicine, LosAngeles, California. is possible that these may represent ischemia occurring MD, Cardiology Section(111C), Veterans AdministrationMedical Address correspondenceandreprint requests toBarryM.Massie, by other mechanisms.1'8-11 Center, 4150 Clement Street, San Francisco, CA 94121. Unfortunately, most of these studies have been con-",
year = "1992",
month = jul,
doi = "10.1093/ajh/5.7.465",
language = "English",
volume = "5",
pages = "465--472",
journal = "American Journal of Hypertension",
issn = "0895-7061",
number = "7",
}