Value of dobutamine technetium-99m-sestamibi SPECT and echocardiography in the detection of coronary artery disease compared with coronary angiography.
The value of dobutamine echocardiography and 99mTc-sestamibi SPECT imaging was evaluated as a noninvasive diagnostic method for assessing coronary artery disease (CAD). Twenty-seven patients who underwent coronary angiography were submitted to two separate injections of 99mTc-sestamibi, one under control conditions and the other after reaching a peak dobutamine infusion rate. Simultaneous ECG and echocardiographic monitoring was also performed during stepwise dobutamine infusion. Whereas the overall sensitivity and specificity of dobutamine sestamibi SPECT imaging were 94% and 88%, these values for dobutamine ECG and echocardiography were 61%, 55% and 84%, 88%, respectively. When dobutamine echocardiography and 99mTc-sestamibi SPECT imaging were evaluated together, the diagnostic accuracy reaches almost 100%. Dobutamine echocardiography is of value in determining ischemic threshold earlier than clinical symptoms and allows simultaneous evaluation of ventricular performance and contractile function associated with perfusion abnormalities on 99,Tc-sestamibi SPECT imaging. Our experience shows that 99mTc-sestamibi SPECT imaging, when combined with dobutamine echocardiography, is a safe, practical, well tolerated method with high diagnostic accuracy for the evaluation of CAD.
Department of Nuclear Medicine, Gülhane Military Medical Academy and Faculty, Ankara, Turkey.
B
B
Günalp
B
B
Dokumaci
C
C
Uyan
E
E
Vardareli
E
E
Işik
H
H
Bayhan
M
M
Ozgüven
E
E
Oztürk
D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis* / Q000453:epidemiology; D004280:Dobutamine; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon
D004280:Dobutamine; D017256:Technetium Tc 99m Sestamibi