CARDIOVASCULAR JOURNAL OF AFRICA • Vol 21, No 3, May/June 2010
AFRICA
147
erythromycin should be considered as an alternative to lemon
juice where patients find it more acceptable and in particular
when taking into account the low cost and the low incidence of
adverse effects.
Our secondary aim was to validate the method as described
by Peace and Lloyd
11
to quantify the amount of interfering extra-
cardiac activity (MYO:EXT). A Xeleris workstation was used to
select the raw anterior projection data and to create ROIs in a
manner similar to the one described. The mean MYO:EXT value
calculated in stress studies with interference was 1.12 compared
to a value of 1.22 in stress studies without interference. Although
these values correlated with the qualitative evaluation, in that
scans without interference resulted in a higher value, the differ-
ence between these values was not statistically significant (
p
=
0.057).
The mean value determined on the rest images with inter-
ference was 1.08 and without interference it was 1.24. Here, a
strong and statistically significant relationship was determined
(
p
=
0.0002). These results suggest that the use of the MYO:EXT
in quantifying the amount of interfering extra-cardiac activity
might be valuable. However, it seems likely that further confirm-
atory studies will be needed and that the quest for the reduction
of interfering extra-cardiac activity continues.
Conclusion
The difference between the effect of erythromycin and lemon
juice on interfering extra-cardiac activity appears statistically
insignificant (
p
=
0.36), and taking into account the better
acceptability of erythromycin, this could be considered a suit-
able alternative to lemon juice. Furthermore, the use of the
MYO:EXT ratio seems promising in our setting.
The authors thank Sr Cecilia Corbett and the rest of the nursing staff and radi-
ographers at the Nuclear Medicine Department of the Steve Biko Academic
Hospital for the practical implementation of this study. Special thanks also
go to the following physicians who interpreted the data: Drs P Mpikashe, N
Soni, W Jansen van Vuuren, NE Nyakale and NP Mokgoro.
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