Simultaneous dobutamine stress echocardiography and dobutamine scintigraphy (99mTc-MIBI-SPET) for assessment of coronary artery disease |
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Authors: | V. Di Bello C. Riccardo Bellina N. Molea L. Talarico G. Boni E. Magagnini F. Matteucci D. Giorgi E. Lazzeri A. Bertini M. F. Romano R. Bianchi C. Giusti |
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Affiliation: | (1) 2nd Institute of Clinical Medicine and Nuclear Medicine Centre, University of Pisa, Italy;(2) Division of Cardiovascular Medicine, Hospital of Pisa, Italy;(3) Department of Statistics and Mathematics Applied to Economics, University of Pisa, Italy;(4) Istituto di Clinica Medica II dell'Università di Pisa, Via Roma 67, I-56100 Pisa, Italy |
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Abstract: | Background: Simultaneous dobutamine stress echocardiography (DSE) and99mTc-MIBI-SPET (DMS) for the evaluation of the presence and the extent of coronary artery disease (CAD) were assessed for a head to head comparison regarding the diagnostic accuracy of the two tests.Methods and Results: Forty-five consecutive patients (33 males and 12 females: 53±6.8 yr.) underwent exercise electrocardiography and simultaneous dobutamine stress echocardiography and MIBI-SPET imaging. Coronary angiography was performed in all patients (significant coronary stenosis > 50%). On the basis of the results of exercise electrocardiogram the pre-test probability for coronary artery disease (Diamond's algorithm) was low (45.6±12.7 %). The overall specificity, sensitivity and predictive accuracy of Echo-dobutamine stress test for diagnosis of the presence or absence of CAD were: specificity 82%, sensitivity 76%, diagnostic accuracy 80%, positive predictive value 90%, negative predictive value 40%. The overall specificity, sensitivity and predictive accuracy of MIBI-SPET-dobutamine test for diagnosis of the presence or absence of CAD were: specificity 86%, sensitivity 87%, diagnostic accuracy 84%, positive predictive value 97%, negative predictive value 54%. MIBI-SPET-dobutamine test showed a significantly higher sensitivity in comparison with ECHO-dobutamine test (P<0.05).Conclusion: Both noninvasive methods for the detection of CAD showed a good diagnostic accuracy. Nevertheless the SPET model showed an higher sensitivity in comparison with DSE model, essentially in the presence of a lower extent of CAD and during submaximal test. |
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Keywords: | dobutamine stress echocardiography myocardial scintigraphy SPET Sestamibi pharmacological stress testing coronary artery disease |
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