[Gated single photon emission computer tomography for the detection of silent myocardial ischemia].
BACKGROUND
Asymptomatic patients with severe coronary atherosclerosis may have a normal resting electrocardiogram and stress test.


OBJECTIVE
To assess the yield of Gated Single Photon Emission Computer Tomography (SPECT) for the screening of silent myocardial ischemia in type 2 diabetic patients.


METHODS
Electrocardiogram, stress test and gated-SPECT were performed on 102 type 2 diabetic patients aged 60+/-8 years without cardiovascular symptoms. AH subjects were also subjected to a coronary angiography whose results were used as gold standard.


RESULTS
Gated-SPECT showed myocardial ischemia on 26.5% of studied patients. The sensibility, specificity accuracy, positive predictive value and negative predictive value were 92.3%, 96%, 95%, 88.8%, 97.3%, respectively. In four and six patients ischemia was detected on resting electrocardiogram and stress test, respectively. Eighty percent of patients with doubtful resting electrocardiogram results and 70% with a doubtful stress test had a silent myocardial ischemia detected by gated-SPECT There was a good agreement between the results of gated-SPECT and coronary angiography (k=0.873).


CONCLUSIONS
Gated-SPECT was an useful tool for the screening of silent myocardial ischemia.
Peña Q
Yamilé
Y
Centro de Investigaciones Clínicas, Ciudad de La Habana, Cuba. yamilepq@infomed.sld.cu
Coca P
Marco Antonio
MA
Batista C
Juan Felipe
JF
Fernández-Britto R
José
J
Quesada P
Rodobaldo
R
Peña C
Andria
A
D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004562:Electrocardiography / Q000379:methods; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D015899:Tomography, Emission-Computed, Single-Photon / Q000592:standards*