title: Feasibility of simultaneous Tc99m sestamibi and 2D-echo cardiac imaging during dobutamine pharmacologic stress. Preliminary results in a female population.
abstract: Feasibility of simultaneous 2D-Echo and SPECT Tc99m Sestamibi imaging during dobutamine infusion was evaluated in a female population with suspected coronary artery disease and scheduled for diagnostic coronary angiography. A total of 49 consecutive subjects were studied. Patients under continuous ECG and 2D-Echo monitoring underwent standard dobutamine infusion at increasing doses to a diagnostic end-point. Tc99m Sestamibi was administered at the peak of the dobutamine effect. With this approach, 35 patients were identified correctly by 2D-Echo (Sensitivity = 60.1%; Specificity = 83.3%; Agreement = 71.4%; k = 0.43). Perfusion imaging with Tc99m Sestamibi resulted in correctly identifying 41 patients (Sensitivity = 83%; Specificity = 84%; Agreement = 83.6%; k = 0.67). Combining information obtained from the two tests resulted in increased specificity (92%) and decreased sensitivity (64%). Simultaneous assessment of perfusion and function with Tc99m Sestamibi and 2D-Echo imaging during dobutamine administration is easily performed without added risk or discomfort to the patient. Tc99m Sestamibi appeared to be slightly superior to 2D-Echo for the detection of CAD in this population, but the difference does not reach conventional statistical significance. The combined use of the two independent tests did not substantially improve the diagnostic accuracy of each method.
authors.affiliation: Istituto di Cardiologia, Ospedale di Udine, Italia.
authors.forename: G A
authors.initials: GA
authors.lastname: Slavich
authors.forename: U P
authors.initials: UP
authors.lastname: Guerra
authors.forename: G
authors.initials: G
authors.lastname: Morocutti
authors.forename: P M
authors.initials: PM
authors.lastname: Fioretti
authors.forename: C
authors.initials: C
authors.lastname: Fresco
authors.forename: C
authors.initials: C
authors.lastname: Orlandi
authors.forename: P G
authors.initials: PG
authors.lastname: Orsolon
authors.forename: T
authors.initials: T
authors.lastname: Forster
authors.forename: G A
authors.initials: GA
authors.lastname: Feruglio
mesh_terms: D000328:Adult; D000368:Aged; D002316:Cardiotonic Agents; D003327:Coronary Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004280:Dobutamine; D004452:Echocardiography; D005240:Feasibility Studies; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008875:Middle Aged; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D002316:Cardiotonic Agents; D019275:Radiopharmaceuticals; D004280:Dobutamine; D017256:Technetium Tc 99m Sestamibi