OBJECTIVES: The purpose of this study was to determine the relative value of dobutamine stress echocardiography and technetium-99m isonitrile single-photon emission computed tomography (mibi SPECT) in the detection of myocardial ischemia. BACKGROUND: Stress-induced new wall motion abnormalities and transient perfusion defects are both used for the diagnosis of myocardial ischemia. METHODS: One hundred five consecutive patients with either proved or suspected coronary artery disease, who were referred for perfusion scintigraphy, were studied by a combination of the two techniques. Both echocardiographic and mibi SPECT images were visually analyzed. Three patients were excluded from the final analysis because of unsatisfactory examinations: two with noninterpretable stress echocardiograms and one with noninterpretable mibi SPECT images. The response to stress was concordantly classified by both techniques in 68% of patients (kappa = 0.51). RESULTS: Dobutamine stress echocardiography revealed the presence of ischemia in 38 and mibi SPECT in 45 patients (overall agreement = 74%, kappa = 0.46). The agreement was higher in patients without previous myocardial infarction (84%, kappa = 0.62). When regional analysis was performed, concordance of stress echocardiography and mibi SPECT occurred in 84% of the 306 regions (kappa = 0.45). Regional agreement was also slightly higher in patients without previous infarction (88%, kappa = 0.50). In 21 patients without previous myocardial infarction who underwent coronary angiography, the overall sensitivity of dobutamine stress echocardiography and mibi SPECT for the diagnosis of coronary artery disease (diameter stenosis > 50%) was 75% and 83%, respectively, with a specificity of 89% (eight of nine patients) for both tests. CONCLUSIONS: Dobutamine stress echocardiography represents a reasonable alternative to dobutamine mibi SPECT for the functional assessment of patients with suspected myocardial ischemia and without previous myocardial infarction.
OBJECTIVES: The purpose of this study was to determine the relative value of dobutamine stress echocardiography and technetium-99m isonitrile single-photon emission computed tomography (mibi SPECT) in the detection of myocardial ischemia. BACKGROUND: Stress-induced new wall motion abnormalities and transient perfusion defects are both used for the diagnosis of myocardial ischemia. METHODS: One hundred five consecutive patients with either proved or suspected coronary artery disease, who were referred for perfusion scintigraphy, were studied by a combination of the two techniques. Both echocardiographic and mibi SPECT images were visually analyzed. Three patients were excluded from the final analysis because of unsatisfactory examinations: two with noninterpretable stress echocardiograms and one with noninterpretable mibi SPECT images. The response to stress was concordantly classified by both techniques in 68% of patients (kappa = 0.51). RESULTS:Dobutamine stress echocardiography revealed the presence of ischemia in 38 and mibi SPECT in 45 patients (overall agreement = 74%, kappa = 0.46). The agreement was higher in patients without previous myocardial infarction (84%, kappa = 0.62). When regional analysis was performed, concordance of stress echocardiography and mibi SPECT occurred in 84% of the 306 regions (kappa = 0.45). Regional agreement was also slightly higher in patients without previous infarction (88%, kappa = 0.50). In 21 patients without previous myocardial infarction who underwent coronary angiography, the overall sensitivity of dobutamine stress echocardiography and mibi SPECT for the diagnosis of coronary artery disease (diameter stenosis > 50%) was 75% and 83%, respectively, with a specificity of 89% (eight of nine patients) for both tests. CONCLUSIONS:Dobutamine stress echocardiography represents a reasonable alternative to dobutamine mibi SPECT for the functional assessment of patients with suspected myocardial ischemia and without previous myocardial infarction.
Authors: Yoshinori Noguchi; Shizuko Nagata-Kobayashi; James E Stahl; John B Wong Journal: Int J Cardiovasc Imaging Date: 2005 Apr-Jun Impact factor: 2.357
Authors: M J Cramer; E E van der Wall; W Jaarsma; J F Verzijlbergen; M G Niemeyer; A H Zwinderman; E K Pauwels Journal: J Nucl Cardiol Date: 1996 Sep-Oct Impact factor: 5.952
Authors: A Elhendy; R T van Domburg; J J Bax; P R Nierop; R Valkema; M L Geleijnse; J D Kasprzak; A F Liqui-Lung; J H Cornel; J R Roelandt Journal: J Nucl Cardiol Date: 1998 Sep-Oct Impact factor: 5.952