[Utility of SPECT with 99m Tc-tetrofosmin and stimulus with dipyridamole in patients with permanent ventricular pacemakers].
OBJECTIVE
Patients with permanent ventricular pacemakers (PP) are a difficult subgroup to assess in the study of coronary artery disease. The objective of this study was to evaluate the diagnostic value of the myocardial perfusion scintigraphy with 99mTC-Tetrofosmin (Tc-Tf) and stimulus with dipyridamole in patients with PP and suspected coronary artery disease.


METHODS
Fourteen patients with suspected coronary artery disease and without structural cardiopathy, who underwent Tc-Tf and cardiac catheterization, were studied retrospectively. Sensitivity, specificity, predictive values and Kappa index were calculated for the diagnosis of coronary artery disease, multivessel disease, and for each one of the coronary arteries (left anterior descending, right coronary, and circumflex). In addition, the correlation between the number of territories with perfusion defects and the number of diseased vessels was studied.


RESULTS
In regards to the diagnosis of coronary artery disease, sensitivity, specificity, positive predictive value, negative predictive value and the Kappa index were 100%, 50%, 83%, 100% and 0.55, respectively. For multi-vessel disease, these values were 83%, 64%, 64%, 83% and 0.43 respectively. The correlation coefficient between the number of territories with perfusion defects and the number of diseased vessels was 0.61 (p = 0.02). In the diagnosis of anterior descending disease, sensitivity and specificity were 83% and 88% respectively. For the right coronary artery, these values were 100% and 44% and for the circumflex artery 38% and 83%, respectively.


CONCLUSIONS
In patients with PP and suspected coronary artery disease, myocardial perfusion scintigraphy with Tc-Tf and stimulus with dipyridamole is of great value in the diagnosis of coronary artery disease and in the assessment of its extension.
Ortega
A
A
Cardiologia. Hospital General Universitario Gregorio Marañón. Madrid.
Moreno
R
R
Alonso
J C
JC
Domínguez
P
P
Almoguera
I
I
Bittini
A
A
Martínez
L
L
Moreno
M
M
Sosa
V
V
García Fernández
M A
MA
Pérez Vázquez
J M
JM
D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000000981:diagnostic imaging* / Q000453:epidemiology; D001145:Arrhythmias, Cardiac / Q000628:therapy*; D006328:Cardiac Catheterization; D015897:Comorbidity; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000187:drug effects; D004176:Dipyridamole / Q000494:pharmacology; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D010138:Pacemaker, Artificial; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon; D014665:Vasodilator Agents / Q000494:pharmacology
D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D014665:Vasodilator Agents; C078700:technetium tc-99m tetrofosmin; D004176:Dipyridamole