[Diagnosis of coronary artery disease: value and limitations of non-invasive methods. (Ecg, thallium perfusion scintigraphy, radionuclide angiography) (author's transl)].
In order to compare the three non-invasive exercise tests Ecg, Thallium myocardial perfusion imaging and radionuclide angiography in the diagnosis of coronary artery disease, the results of these tests in a consecutive series of 30 patients and 14 controls were analyzed. In all 88 symptom-limited exercise tests a significantly higher double product (heart rate x systolic blood pressure, mm Hg/min) was reached on a treadmill test (for Ecg and Thallium scintigraphy) as compared to the supine bicycle ergometer exercise (for radionuclide angiography: 243.1 +/- 61.1 vs. 215.2 +/- 46.5 x 10(2) (p less than 0.01). Considering all 132 diagnostic tests the overall sensitivity for rest/exercise Ecg was 67%, for Thallium scans 77%, for both combined 83% and for the ejection fraction response to exercise determined by radionuclide angiography 97%. If only the exercise response was considered, the corresponding sensitivity values were 60% (Ecg), 47% (Thallium scans), 70% (both tests combined) and 97% (radionuclide angiography). The specificity for coronary artery disease was determined to be 79% for Ecg, 86% for Thallium scintigraphy, 64% for Ecg/Thallium scans and 71% for radionuclide angiography. The most common reason for a false-positive result in all tests was found to be the diagnosis of cardiomyopathy, whereas most false-negative results were seen in patients with single vessel right coronary artery disease. Based on these results, the clinical implications of the three non-invasive tests in the diagnosis of coronary artery disease are discussed.
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004562:Electrocardiography; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011868:Radioisotopes; D011877:Radionuclide Imaging; D013793:Thallium
D011868:Radioisotopes; D013793:Thallium
Diagnostik der koronaren Herzkrankheit Möglichkeiten und Grenzen von nichtinvasiven Methoden (Ekg, Thallium-Perfusions-Szintigraphie, Radionuklid-Angiographie).