Investigations into the methodology of intramyocardial scintiscanning and its uses in the diagnosis and differential diagnosis of coronary heart disease

Some 3000 patients were subjected to radionuclide ventriculography (RNV) in order to assess their cardiac functions. The individual steps involved in the procedure were in vivo/in vitro 99m-Tc labelling of erythrocyte DPNA using a method developed by myself, an ECG-triggered system, further an uptake programme permitting reconstruction of the cardiac rhythm that was also developed by myself, and eventually an evaluation programme ensuring a detailed and reproducible analysis of the overall and regional cardiac function. In order to compare and validate the results thus obtained, additional examinations were carried out using 99m-Tc HSA as a tracer substance as well as contrast-enhanced angiography both at rest and during exercise. In comparison with other non-invasive methods - ECG recordings during exercise and myocardial scintiscanning using TL-201-RNV was found to be the most sensitive ans presumably also the most specific technique to diagnose coronary heart disease (CHD). If its high diagnostic accuracy is, however, balanced against the costs involved, it becomes obvious that it cannot be recommended as a large-scale screening method. RNV certainly is indicated in selected groups of patients showing a prevalence of intermediary clinical symptoms, to monitor the cardiac function in various diseases of the heart and to assess the effectiveness of drug and surgical treatments, provided that the relative risks, costs and diagnostic value of the data obtained are weighed up carefully. (TRV)