COMPARISON OF TC-99M SESTAMIBI-PERFUSION IMAGING AND ECHOCARDIOGRAPHYUSING AN ARBUTAMINE-INFUSION FOR THE DETECTION OF CORONARY-ARTERY-DISEASE

Pharmacologic stress testing is a useful alternative to exercise for t he detection and assessment of coronary artery disease (CAD). Vasodila ting agents, ;such as dipyridamole and adenosine, provoke regional blo od flow disparities,(1,2) as well as regional wall motion abnormalitie s.(2-4) Despite excellent safety and efficacy of these agents, they ar e contraindicated in patients with reactive airway disease.(1,5,6) Vas odilator infusions with echocardiography may also have significant lim itations in producing new regional wall motion abnormalities.(3,4) Dob utamine has been shown to be an alternative to vasodilators when used in conjunction with myocardial perfusion imaging,(2,7-9) and dobutamin e echocardiography is also a useful method for the diagnosis of corona ry disease.(2-4,10) Arbutamine, a synthetic catecholamine with propert ies similar to dobutamine, may be infused using a computer-controlled infusion system, and appears to be safe and effective for the detectio n of CAD in conjunction with echocardiography and thallium scintigraph y.(11-13) There are no data regarding the diagnostic utility of arbuta mine with perfusion agents other than thallium-201. We sought to analy ze the diagnostic value of arbutamine technetium (Tc)-99m sestamibi pe rfusion imaging and directly compare perfusion imaging with echocardio graphy after an arbutamine infusion.