Koss J H, Kobren S M, Grunwald A M, Bodenheimer M M
Am J Cardiol. 1987 Mar 1;59(6):531-4. doi: 10.1016/0002-9149(87)91163-5.
While exercise thallium imaging has improved sensitivity and specificity for detection of coronary artery disease (CAD), its predictive value for morbid cardiac events is unclear. Of 532 consecutive patients who underwent exercise thallium imaging, follow-up was complete in 515 (97%) after an average of 36 months (range 31 to 48). Two hundred six patients had an abnormal exercise thallium response and 309 had a normal response. Twenty morbid cardiac events occurred (13 deaths and 7 acute myocardial infarctions [AMI]). Of the 13 patients who died, 12 had abnormal thallium results. Overall, 5.8% of the patients with abnormal thallium results died, in contrast to 0.3% of patients with normal results. Of the 7 patients who had a nonfatal AMI, 3 had abnormal exercise thallium results. Moreover, similar proportions of patients (1.4% and 1.3%) with normal and abnormal exercise thallium results had nonfatal AMI. Presence or absence of pathologic Q waves and inclusion of exercise electrocardiographic results did not significantly alter the results. Thus, although a normal exercise thallium response significantly reduces the likelihood of cardiovascular death, its predictive value for nonfatal AMI is limited. Moreover, the relatively low event rate for patients with a positive exercise thallium response further limits its prognostic value.
虽然运动铊显像提高了检测冠状动脉疾病（CAD）的敏感性和特异性，但其对心脏不良事件的预测价值尚不清楚。在532例连续接受运动铊显像的患者中，平均36个月（范围31至48个月）后，515例（97%）完成了随访。206例患者运动铊反应异常，309例反应正常。发生了20例心脏不良事件（13例死亡和7例急性心肌梗死[AMI]）。在13例死亡患者中，12例铊结果异常。总体而言，铊结果异常的患者中有5.8%死亡，而结果正常的患者中这一比例为0.3%。在7例非致命性AMI患者中，3例运动铊结果异常。此外，运动铊结果正常和异常的患者发生非致命性AMI的比例相似（分别为1.4%和1.3%）。病理性Q波的有无以及运动心电图结果的纳入并未显著改变结果。因此，虽然运动铊反应正常可显著降低心血管死亡的可能性，但其对非致命性AMI的预测价值有限。此外，运动铊反应阳性患者的事件发生率相对较低，进一步限制了其预后价值。
