title: Non-invasive diagnosis of coronary artery disease by 123I-BMIPP/201TlCl dual myocardial SPECT in patients with heart failure.
abstract: OBJECTIVE
  Detecting the presence of coronary artery disease (CAD) is critically important in managing patients with heart failure of uncertain cause. The recently introduced 123I-BMIPP/201TlCl dual myocardial single-photon emission computed tomography (dual SPECT) is potentially a non-invasive diagnostic tool in detecting ischemic heart disease. The aim of our study is to evaluate the efficacy of detecting CAD by dual SPECT in patients with heart failure.
  
  
  METHODS
  We studied 501 consecutive patients (366 males, mean age 68±12 years) who were admitted because of heart failure between January 2005 and April 2009. In all patients, the dual SPECT was performed in clinically stabilized states, followed by coronary angiography within 1 week. The polar map of the SPECT image was divided into 17 segments, each scored on a scale of 0-4 based on segmental percent uptake. The mismatch score was defined as the difference between 123I-BMIPP defect score and 201TlCI defect score. The uptake of 201TlCl and 123I-BMIPP was analyzed quantitatively using the Heart Score View software.
  
  
  RESULTS
  The 201TlCI defect score and mismatch score were significantly higher in CAD patients than in non-CAD patients. The receiver operating characteristic (ROC) curve revealed that the mismatch score was a significantly more effective marker in detecting the presence of CAD than 201TlCl defect score (area under the curve: 0.84 versus 0.73, p<0.05). Using the mismatch score, the sensitivity and specificity of dual SPECT in detecting CAD were 84% and 83%, respectively.
  
  
  CONCLUSIONS
  Dual SPECT is a useful non-invasive procedure for the detection of CAD in patients with heart failure.
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu-shi, Tokyo 183-0003, Japan. Electronic address: abe-cib@umin.ac.jp.
authors.forename: Hajime
authors.initials: H
authors.lastname: Abe
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu-shi, Tokyo 183-0003, Japan. Electronic address: niguchi@shi.heart.or.jp.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Iguchi
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu-shi, Tokyo 183-0003, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Utanohara
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu-shi, Tokyo 183-0003, Japan.
authors.forename: Kanki
authors.initials: K
authors.lastname: Inoue
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu-shi, Tokyo 183-0003, Japan.
authors.forename: Itaru
authors.initials: I
authors.lastname: Takamisawa
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu-shi, Tokyo 183-0003, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Seki
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu-shi, Tokyo 183-0003, Japan.
authors.forename: Kouhei
authors.initials: K
authors.lastname: Tanizaki
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Takeda
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu-shi, Tokyo 183-0003, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tohbaru
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu-shi, Tokyo 183-0003, Japan.
authors.forename: Ryuta
authors.initials: R
authors.lastname: Asano
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu-shi, Tokyo 183-0003, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Nagayama
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu-shi, Tokyo 183-0003, Japan.
authors.forename: Morimasa
authors.initials: M
authors.lastname: Takayama
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu-shi, Tokyo 183-0003, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Umemura
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu-shi, Tokyo 183-0003, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sumiyoshi
authors.affiliation: Department of Cardiology, Sakakibara Heart Institute, 3-16-1 Asahicho, Fuchu-shi, Tokyo 183-0003, Japan.
authors.forename: Hitonobu
authors.initials: H
authors.lastname: Tomoike
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis*; D005227:Fatty Acids; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013793:Thallium; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D005227:Fatty Acids; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D013794:Thallium Radioisotopes; C049338:iodofiltic acid; C027549:thallium chloride; D013793:Thallium
keywords: Heart failure; Imaging; Ischemia; Nuclear medicine