title: Early dipyridamole stress myocardial SPECT to detect residual stenosis of infarct related artery: comparison with coronary angiography and fractional flow reserve.
abstract: BACKGROUND
  The detection of residual stenosis of infarct related artery (IRA) at early stage after acute myocardial infarction (AMI) is crucial in clinical decision making for interventional revascularization. The aim of this study was to evaluate the relevancy of early dipyridamole stress myocardial SPECT to detect functionally and luminologically significant residual stenosis of IRA after AMI.
  
  
  METHODS
  Twenty five consecutive patients (M:F = 19:6, age: 56 +/- 13 yrs) with AMI underwent SPECT and coronary angiography within 5 days of the attack. Infarct related arteries with FFR < 0.75 and diameter stenosis (DST) > 70% were regarded to have functionally and morphologically significant residual stenosis. Reversible perfusion defect was defined if there was improvement of the perfusion score more than one grade in infarct segments on rest images of SPECT compared with stress images.
  
  
  RESULTS
  Mean FFR and DST were 0.76 +/- 0.14 and 74 +/- 15%. SPECT showed no significant correlation with both FFR and DST with Kendall's coefficiency of 0.28 (p = 0.05) and 0.13 (p = 0.35). The sensitivity and specificity of SPECT to detect functionally and morphologically significant residual stenosis were 92%, 31% and 83%, 29%.
  
  
  CONCLUSIONS
  The early dipyridamole stress myocardial SPECT after AMI does not seem to be a useful non-invasive test for the detection of functionally and luminologically significant residual stenosis of IRA.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Inha University College of Medicine, 7-206, Shinheung-Dong 3-Ga, Jung-Ku, Inchon, Korea, 400-103.
authors.forename: Jeong Kee
authors.initials: JK
authors.lastname: Seo
authors.forename: Jun
authors.initials: J
authors.lastname: Kwan
authors.forename: Ju Hyun
authors.initials: JH
authors.lastname: Suh
authors.forename: Dae Hyeok
authors.initials: DH
authors.lastname: Kim
authors.forename: Ki Hoon
authors.initials: KH
authors.lastname: Lee
authors.forename: In Young
authors.initials: IY
authors.lastname: Hyun
authors.forename: Won Sick
authors.initials: WS
authors.lastname: Choe
authors.forename: Keum Soo
authors.initials: KS
authors.lastname: Park
authors.forename: Woo Hyung
authors.initials: WH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D017023:Coronary Angiography; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004176:Dipyridamole; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D004176:Dipyridamole