English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

The sensitivity of stress myocardial perfusion scintigraphy for detecting coronary artery disease (CAD) in patients with multivessel CAD is high. 1-4 However, its ability to predict the presence of multivessel disease is limited. It has been suggested that the presence of left main or multivessel disease is missed in up to 50% of cases. 5,6 The possible reasons for this include balanced perfusion abnormality, where the absence of a normal reference segment limits sensitivity, early plateau of tracer uptake, which limits detection of borderline stenoses, and early stoppage of exercise as a result of symptoms or signs due to the severest lesion. There is evidence that ancillary clinical, exercise, and scan variables can improve the sensitivity of a gated SPECT myocardial perfusion study for detection of multivessel CAD. 7 These include poor exercise tolerance and development of chest pain and/or electrocardiographic evidence of ischemia at a low exercise workload, 8 increased lung/heart tracer uptake ratio, 9 and transient ischemic dilation of the left ventricle following stress (TID), which was shown to be a specific but fairly insensitive marker of multivessel CAD. Initial studies with planar Tl-201 imaging found a cut-off TID ratio of 1.12 to have the best sensitivity and specificity for detecting multivessel CAD. A subsequent study with dual-isotope imaging reported an optimal cut-off of 1.22. 10 Other approaches include integration of functional assessment by gated SPECT with conventional perfusion analysis; 3,11 comparison of RV to LV activity,

Detection of multivessel coronary artery disease: looking beyond the extent of perfusion abnormalities