[Evaluation of the severity of coronary disease by thallium 201 myocardial scintigraphy and technetium 99m isotope ventriculography. Comparison of the 2 methods apropos of 30 cases].

The evaluation of the severity of coronary artery disease by non-invasive methods may involve the use of isotope techniques. The authors compared the results of technetium 99m cardiac functional angioscintigraphy and thallium 201 myocardial scintigraphy, performed at rest and on effort, in a group of 30 patients. The 30 patients consisted of 6 normal patients (control group) and 24 patients with coronary artery disease (8 cases of angina; 16 infarcts, including 12 inferior infarcts). Coronary angiography revealed 13 cases of one vessel disease, 8 cases of two vessel disease and 3 cases of three vessel disease. The results of angioscintigraphy revealed that the technique was reliable in terms of the evaluation of the abnormalities of contraction (sensitivity: 96%, compared with the results of haemodynamics) and that the study of the ejection fractions at rest and on effort was particularly valuable. The ejection fractions calculated by the isotope method were not statistically different from the ejection fractions calculated by the haemodynamic method. The patients with one vessel disease and the normal subjects increased their ejection fraction on effort by about 12% (p = 0.03), in contrast with the patients with multiple vessel disease, who increased their ejection fraction on effort by 2% (p greater than 0.05). In contrast, the results of myocardial scintigraphy at rest and on effort were disappointing. The method was specific (100%), but in our series, its sensitivity was only 72% for the group of patients with coronary artery disease. In cases with infarction and multiple vessel disease, the zone of the infarction was always detected, but no other abnormalities were observed in the other territories.(ABSTRACT TRUNCATED AT 250 WORDS)