Clinical usefulness of ventricular function and myocardial perfusion

pp 12-23

Abstract

To evaluate the clinical usefulness of the ventricular function (VF) and myocardial perfusion (MP) simul. taneous test (ST), thirty consecutive patients were studied prospectively. All patients underwent the following studies: stress/rest (SIR) ST with hexakis 2 methoxy 2 isobutil isonitrilo labeled with Tc-99m, (MIBI-Tc 99m), and radionuclide ventriculography with Tc-99m (RV-Tc 99m), S and redistribution thallium 201 (TL-201) test as well as CCG. The ST consisteif of acquisition of the first pass (FP) of radioactive bolus wich allows as to analyze VF, wall motion (WM) and MP simultaneously. The aims of 1his study were: 1) validation of the diagnostic method determining the sensibility (Se) and specificity (Sp) of the ST in the detection of coronary artery disease (CAD) and myocardial-ischemia (MI) in each vascular territory; 2) its comparison with TL-201, RV.Tc 99m and CCG. The regression curves between 1he ST and the R V - T c 99m showed a correlation of 0.92 and 0.89 for 1he ejection fraction and WM respectively in R and of 0.90 and 0.85 in S. The correlation between the myocardial perfusion score with TL-201 and MIBI-Tc 99m was 0.94 and 0.82 in R/S. Tbe overall Se of ST, R V.Tc 99m and TL201 were 93, 89.6, and 89.6 % respectively. The ability to detect severe CAD, was 93, and 90 % for TL-201 and MIBI-Tc 99m respectively. Of the 540 segments analysed in the perfusion test, there was an agreement rate of 85% between TL201 and MIBI. Tc 99m. In the detection of normal, ischemic and necrotic segments there was an agreement rate of 95 %, 94 % and 85 % respectively for the TL-201 and MIBI. Tc 99m. In summary: 1) The ST has a high Se for the detection of CAD. 2) When analysing WM, the Seand Sp of the ST was similar to 1he RV-Tc 99m. 3) The ST evidenced a Se and Sp similar to that TL-201 and T c 99m for the detection of ischemia in each ventricular segment. 4) The Se of the perfusion test with MIBI.Tc 99m was slightly lower compared to 1he TL-201 test. We conclude that the information on the VF and its relation to MP obtained from only one study with the ST is similar to that obtained from two different ones: TL201 and RV.Tc 99m stress tests.