[Comparison of segmental wall motion in electrocardiogram-gated myocardial scintigraphy and transthoracic echocardiography].
ECG-gated myocardial scintigraphy (Gspect) is a recent method of assessing myocardial perfusion, left ventricular ejection fraction and regional wall motion in a single investigation. It reduces the time required for the evaluation of coronary patients by radionucleide cardiology. Many reports have validated the measurement of the left ventricular ejection fraction compared with other methods. However, there are fewer series reporting the results of regional wall motion. The authors compared segmental wall motion by Gspect after injecting Thallium or Mibi and by transthoracic echocardiography in 47 patients or 423 myocardial segments. The concordance of score (normal, hypokinetic, akinetic, dyskinetic) was 75% (Kappa = 0.538). If analysis was limited to a normal-abnormal differentiation (binary analysis) it increased to 83%. When perfusion was taken into consideration, it was 81% (normal perfusion), 63% (mild hypoperfusion) and 70% (moderate and severe hypoperfusion). This concordance improved in binary analysis respectively to 85, 74 and 86% respectively. When the typs of segment was taken into consideration, concordance varied from 57 to 100%. The concordances were 74% for Thallium and 78% for Mibi scintigraphy, improving to 82% and 85% respectively in binary analysis. Thus, analysis of LV regional wall motion by Gspect is comparable to transthoracic echocardiography. This result, completed by measurement of LV ejection fraction and of myocardial perfusion, provides a method of evaluation of coronary patients in a single investigation.
Levy
M
M
Service de cardiologie, HEP La Roserale, Aubervilliers.
Bekri
N
N
Pouillart
F
F
Bellorini
M
M
Romano
M
M
Perez
T
T
Palsky
E
E
D000368:Aged; D003327:Coronary Disease / Q000175:diagnosis / Q000000981:diagnostic imaging; D004452:Echocardiography / Q000379:methods*; D005260:Female; D015637:Gated Blood-Pool Imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D016277:Ventricular Function, Left