BACKGROUND: Technetium-99m tetrofosmin single photon emission computed tomography (SPECT) imaging is increasingly used in conjunction with exercise and vasodilator stress test as a means of evaluating coronary artery disease (CAD). Dobutamine stress test is an alternative in patients with limited exercise capacity. This study assessed the accuracy of dobutamine-atropine stress tetrofosmin SPECT as a means of diagnosing and localizing CAD. METHODS AND RESULTS: We studied 124 patients (mean age, 57+/-12 years; 88 men) with limited exercise capacity and suspected CAD with dobutamine (as much as 40 microg/kg/min)-atropine (as much as 1 mg) Tc-99m tetrofosmin SPECT. Resting images were acquired 24 hours after the stress test. Significant CAD was defined as 50% or greater luminal diameter stenosis in 1 or more major coronary arteries. Myocardial perfusion abnormalities (fixed and/or reversible defects) were detected in 70 of 88 patients with CAD and in 10 of the 36 patients without CAD (sensitivity = 80%, CI, 72 to 87; specificity = 72%, CI, 64 to 80; accuracy = 77%, CI, 70 to 85). Sensitivity and accuracy rates were higher by using the criterion of any defect than by using the criterion of reversible defects only (80% vs 51%, P<.0001; 77% vs 60%, P<.01, respectively). The sensitivity rate was higher in patients with multivessel CAD than in patients with single-vessel CAD (88% vs 63%, P<.05). Patients with multivessel CAD had a larger stress perfusion defect score (4.5+/-3.1 vs. 2.7+/-2.5, P<.01) than patients with single-vessel CAD. CONCLUSION: Dobutamine stress Tc-99m tetrofosmin SPECT is a useful method for the diagnosis and localization of CAD in patients with limited exercise capacity. Optimal accuracy of the technique is achieved by using both fixed and reversible perfusion abnormalities for the diagnosis of CAD in patients without an earlier myocardial infarction.
BACKGROUND: Technetium-99m tetrofosmin single photon emission computed tomography (SPECT) imaging is increasingly used in conjunction with exercise and vasodilator stress test as a means of evaluating coronary artery disease (CAD). Dobutamine stress test is an alternative in patients with limited exercise capacity. This study assessed the accuracy of dobutamine-atropine stress tetrofosmin SPECT as a means of diagnosing and localizing CAD. METHODS AND RESULTS: We studied 124 patients (mean age, 57+/-12 years; 88 men) with limited exercise capacity and suspected CAD with dobutamine (as much as 40 microg/kg/min)-atropine (as much as 1 mg) Tc-99m tetrofosmin SPECT. Resting images were acquired 24 hours after the stress test. Significant CAD was defined as 50% or greater luminal diameter stenosis in 1 or more major coronary arteries. Myocardial perfusion abnormalities (fixed and/or reversible defects) were detected in 70 of 88 patients with CAD and in 10 of the 36 patients without CAD (sensitivity = 80%, CI, 72 to 87; specificity = 72%, CI, 64 to 80; accuracy = 77%, CI, 70 to 85). Sensitivity and accuracy rates were higher by using the criterion of any defect than by using the criterion of reversible defects only (80% vs 51%, P<.0001; 77% vs 60%, P<.01, respectively). The sensitivity rate was higher in patients with multivessel CAD than in patients with single-vessel CAD (88% vs 63%, P<.05). Patients with multivessel CAD had a larger stress perfusion defect score (4.5+/-3.1 vs. 2.7+/-2.5, P<.01) than patients with single-vessel CAD. CONCLUSION:Dobutamine stress Tc-99m tetrofosmin SPECT is a useful method for the diagnosis and localization of CAD in patients with limited exercise capacity. Optimal accuracy of the technique is achieved by using both fixed and reversible perfusion abnormalities for the diagnosis of CAD in patients without an earlier myocardial infarction.
Authors: H Shanoudy; P Raggi; G A Beller; A Soliman; E G Ammermann; R J Kastner; D D Watson Journal: J Am Coll Cardiol Date: 1998-02 Impact factor: 24.094
Authors: M G Levine; A W Ahlberg; A Mann; M P White; C C McGill; C Mendes de Leon; J M Piriz; D Waters; G V Heller Journal: J Nucl Cardiol Date: 1999 Jul-Aug Impact factor: 5.952
Authors: R Montz; M J Perez-Castejón; J A Jurado; J Martín-Comín; E Esplugues; L Salgado; A Ventosa; G Cantinho; E P Sá; A T Fonseca; M R Vieira Journal: Eur J Nucl Med Date: 1996-06
Authors: A Cuocolo; E Nicolai; A Soricelli; L Pace; A Nappi; P Sullo; S Cardei; L Argenziano; P J Ell; M Salvatore Journal: J Nucl Cardiol Date: 1996 May-Jun Impact factor: 5.952
Authors: Abdou Elhendy; Arend F L Schinkel; Ron T van Domburg; Jeroen J Bax; Roelf Valkema; Don Poldermans Journal: J Nucl Cardiol Date: 2004 Nov-Dec Impact factor: 5.952
Authors: Abdou Elhendy; Arend F l Schinkel; Ron T van Domburg; Jeroen J Bax; Roelf Valkema; Don Poldermans Journal: J Nucl Cardiol Date: 2003 Nov-Dec Impact factor: 5.952