Feasibility of simultaneous Tc99m sestamibi and 2D-echo cardiac imaging during dobutamine pharmacologic stress
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Feasibility of simultaneous 2D-Echo and SPECT Tc99m Sestamibi imaging during dobutamine infusion was evaluated in a female population with suspected coronary artery disease and scheduled for diagnostic coronary angiography. A total of 49 consecutive subjects were studied. Patients under continuous ECG and 2D-Echo monitoring underwent standard dobutamine infusion at increasing doses to a diagnostic end-point. Tc99m Sestamibi was administered at the peak of the dobutamine effect. With this approach, 35 patients were identified correctly by 2D-Echo (Sensitivity = 60.1%; Specificity = 83.3%; Agreement = 71.4%; k = 0.43). Perfusion imaging with Tc99m Sestamibi resulted in correctly identifying 41 patients (Sensitivity = 83%; Specificity = 84%; Agreement = 83.6%; k=0.67). Combining information obtained from the two tests resulted in increased specificity (92%) and decreased sensitivity (64%). Simultaneous assessment of perfusion and function with Tc99m Sestamibi and 2D-Echo imaging during dobutamine administration is easily performed without added risk or discomfort to the patient. Tc99m Sestamibi appeared to be slightly superior to 2D-Echo for the detection of CAD in this population, but the difference does not reach conventional statistical significance. The combined use of the two independent tests did not substantially improve the diagnostic accuracy of each method.
Key words2D-echo Tc99m Sestamibi CAD women
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- 10.Chatterjee K. ‘Dobutamine, a ten year review.’ New York: NCM, 1989.Google Scholar
- 12.Kahn JK, McGlie I, Akers MS, Sills MN, Faber TL, Kulkarni PV, Wilkerson JT, Corbett JR. Quantitative rotational tomography with 201 Tl and 99m Tc 2-Methoxy Isobutyl Isonotrile, a direct comparison in normal individuals and patients with coronary artery disease. Circulation 1989; 79: 1282–93.PubMedGoogle Scholar
- 13.Altman DG. Practical statistics for medical research. London: Chapman and Hall, 1991: 404–8.Google Scholar
- 19.Lane RT, Sawada SG, Ryan T, Armstrong WF, Feigenbaum H. Dobutamine stress echocardiography as a predictor of perioperative cardiac events. Circulation 1989; 80 (suppl II): II-67.Google Scholar
- 20.Previtali M, Lanzarini L, Ferrario M, Tortorici M, Mussini A, Montemartini C. Dobutamine versus dipyridamole echocardiography in coronary artery disease. Circulation 1991; 83 (suppl III): III-27-31.Google Scholar
- 22.Forster T, McNeil AJ, Salustri A, Reijs AEM, El-Said EM, Roelandt JRTC, Fioretti PM. Simultaneous dobutamine stress echocardiography and technetium 99m isonitrile single photon emission computed tomography in patients with suspected coronary artery disease. J Am Coll Cardiol 1993; 21: 1591–6.PubMedGoogle Scholar