VALIDITY OF MYOCARDIAL PERFUSION IMAGING FOR THE DETECTION OF CORONARY ARTERY DISEASE
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Khan, S., Zaib, S., Ashraf, A., & Mohammad Hafizullah, M. (2013). VALIDITY OF MYOCARDIAL PERFUSION IMAGING FOR THE DETECTION OF CORONARY ARTERY DISEASE. KHYBER MEDICAL UNIVERSITY JOURNAL, 5(2). Retrieved from https://www.kmuj.kmu.edu.pk/article/view/76-80

Abstract

Objective: To determine validity of myocardial perfusion imaging for the detection of coronary artery disease.

Methodology: This was a hospital based observational study, conducted in department of Cardiology, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar, K.P.K, from May 2008 to Jun 2009. Myocardial perfusion imaging was performed for all patients and invasive coronary angiography was taken as gold standard for the detection of coronary artery disease.

 

Results: Total number of patients was 50; their mean age was 53.8±9.7 years. Men were 35 (70%) and women were 15 (30%). Myocardial perfusion imaging was reported as normal in 5(10%) patients while 45 (90%) had abnormal results. Coronary angiography showed 44 patients (88%) had > 50% stenosis in at least one coronary artery. Compared with coronary angiography, the sensitivity, specificity, positive predictive value and negative predictive values of myocardial perfusion imaging for detection of CAD were 98%, 67%, 95%, and 80% respectively. The sensitivity for the detection of ischemia in LAD, RCA, and CIRC territories were 89.7%, 94.7% and 72.2% respectively.

 

Conclusion: Myocardial perfusion imaging has a high sensitivity for identifying patients with coronary artery disease.

 

KEY WORDS: Myocardial perfusion imaging, Coronary artery disease, Coronary angiography

 

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References

Klocke FJ, Baird MG, Lorell BH. ACC/

AHA/ASNC guidelines for the clinical use

of cardiac radionuclide imaging -- executive

summary: a report of the American

College of Cardiology/American Heart

Association Task Force on Practice Guidelines

(ACC/AHA/ASNC Committee to

Revise the 1995 Guidelines for the Clinical

Use of Cardiac Radionuclide Imaging).

Circulation 2003; 108: 1404-18.

Bart BA, Erlien DA, Herzog CA, Asinger

RW. Marked differences between patients

referred for stress echocardiography and

myocardial perfusion imaging studies. Am

Heart J 2005; 149(5): 888-93.

Kuntz KM, Fleischmann KE, Hunink MG,

Douglas PS. Cost effectiveness of diagnostic

strategies for patients with chest

pain. Ann Intern Med 2002; 130: 709-18.

Garber AM, Solomon NA. Cost effectiveness

of alternative test strategies for the

diagnosis of coronary artery disease. Ann

Inter Med 2002; 130: 719-28.

Gibbons RJ, Balady GJ, Bricker JT. ACC/

AHA 2002 guideline update for exercise

testing: A report of the ACC/AHA Task

Force on Practice Guidelines. Circulation

; 106: 1883.

Islam ZU, Kango ZA. Normal exercise

tolerance test in a patient with severe main

coronary artery disease. J Coll Physicians

Surg Pak 2004; 14(3): 178-9.

Myers J, Prakash M, Froelicher V. Exercise

capacity and mortality among men

referred for exercise testing. N Eng J Med

; 346: 793.

Gibbons RJ, Abrams J, Chatterjee K. ACC/

AHA 2002 guideline update for the management

of patients with chronic stable

angina- summary article: A report of the

ACC/AHA Task Force on Practice Guidelines.

J Am Coll Cardiol 2003; 41: 159-68.

Gianrossi R, Detrano R, Mulvihill D, Lehmann

K, Dubach P. Exercise-induced ST

depression in the diagnosis of coronary

artery disease. A meta-analysis. Circulation.

; 80: 87-98.

DeFilippi CR, Rosanio S, Tocchi M, Parmar

RJ, Potter MA, Uretsky BF, et al.

Randomized comparison of a strategy of

predischarge coronary angiography versus

exercise testing in low-risk patients in a

chest pain unit: in-hospital and long-term

outcomes. J Am Coll Cardiol. 2001; 37:

-9.

Elhendy A, Bax JJ, Poldermans D. Dobutamine

stress myocardial perfusion imaging

in coronary artery disease. J Nucl Med

; 43: 1634-46.

Kapur A, Latus KA, Davies G. A comparison

of three radionuclide myocardial

perfusion tracers in clinical practice: the

ROBUST study. Eur J Nucl Med 2002;

: 1608-16.

Kontos MC, Kurdziel K, McQueen R,

Arrowood JA, Jesse RL, Ornato JP, et al:

Comparison of 2-dimensional echocardiography

and myocardial perfusion imaging

for diagnosing myocardial infarction in

emergency department patients. Am

Heart J 2002, 143: 659-67.

Mieres JH, Rosman DR, Shaw LJ. Stress

myocardial perfusion imaging in the diagnosis

of women with suspected coronary

artery disease. Curr Cardiol Rep. 2004

Jan; 6(1): 27-31.

Rehman A, Shah SA, Khan RA. Comparison

of myocardial perfusion imaging

studies with technetium 99 tetrofosmin

and coronary angiography findings in non

diabetic and diabetic patients of ischemic

heart disease. Pakistan J Cardiol 2003;

(1): 15-21.

McCully RB, Roger VL, Mahoney DW.

Outcome after normal exercise

echocardiography and predictors

of subsequent cardiac events: follow-

up of 1,325 patients. J Am Coll

Cardiol 1998; 31: 144-9.17. Brown KA. Prognostic value of thallium-

myocardial perfusion imaging. A

diagnostic tool comes of age. Circulation

; 83: 363-81.

Underwood SR, Anagnostopoulos C,

Cerqueira M. Myocardial perfusion scintigraphy:

the evidence. Eur J Nucl Med Mol

Imaging 2004; 31: 261-91.

Berman DS, Kang X, Nishina H. Diagnostic

accuracy of gated Tc-99m sestamibi

stress myocardial perfusion SPECT with

combined supine and prone acquisitions

to detect coronary artery disease in obese

and nonobese patients. J Nucl Cardiol

; 13: 191-201.

Caner B, Karanfil A, Uysal U. Effect of an

additional atropine injection during dobutamine

infusion for myocardial SPECT.

Nucl Med Commun 1997; 18: 567-73.

Hays JT, Mahmarian JJ, Cochran AJ, Verani

MS. Dobutamine thallium-201 tomography

for evaluating patients with suspected

coronary artery disease unable to undergo

exercise or vasodilator pharmacologic

stress testing. J Am Coll Cardiol 1993;

: 1583-90.

Günalp B, Dokumaci B, Uyan C. Value

of dobutamine technetium-99m-sestamibi

single-photon emission computed

tomography and echocardiography in

the detection of CAD compared with

coronary angiography. J Nucl Med 1993;

: 889-94.

Senior R, Sridhara BS, Anagnostou E,

Handler C, Raftery EB, Lahiri A. Synergistic

value of simultaneous stress dobutamine

sestamibi single-photon emission computerized

tomography and echocardiography

in the detection of coronary artery disease.

Am Heart J. 1994; 128; 713-18.

Elhendy A, Sozzi FB, Valkema R, van Domburg

RT, Bax JJ, Roelandt JR. Dobutamine

technetium-99m tetrofosmin SPECT imaging

for the diagnosis of coronary artery

disease in patients with limited exercise

capacity. J Nucl Cardiol 2000; 7: 649-54.

Elhendy A, van Domburg RT, Bax JJ.

Noninvasive diagnosis of coronary artery

stenosis in women with limited exercise

capacity: comparison of dobutamine stress

echocardiography and 99mTc sestamibi

single-photon emission CT. Chest. 1998;

: 1097-1104.

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