Incremental value of regional wall motion analysis immediately after exercise for the detection of single-vessel coronary artery disease: study by separate acquisition, dual-isotope ECG-gated single-photon emission computed tomography

Circ J. 2005 Mar;69(3):301-5. doi: 10.1253/circj.69.301.

Abstract

Background: Although the detection of wall motion abnormalities gives incremental value to myocardial perfusion single-photon emission computed tomography (SPECT) in the diagnosis of extensive coronary artery disease (CAD) and high-grade single-vessel CAD, whether or not it is useful in the diagnosis of mild, single-vessel CAD has not been studied previously.

Methods and results: Separate acquisition, dual isotope ECG-gated SPECT was performed in 97 patients with a low likelihood of CAD (Group 1) and 46 patients with single-vessel CAD (Group 2). Mild CAD was defined by stenosis of 50-75% (Group 2a, n=22) and moderate to severe CAD was defined by stenosis >/=76% (Group 2b, n=24). Myocardial perfusion and wall motion were graded by a 5 point-scale, 20-segment model. The sensitivity of myocardial perfusion alone was 50% for Group 2a, 83% for Group 2b and 67% for Group 2 as a whole. The overall specificity was 90%. When the wall motion analysis was combined, the sensitivity was increased to 82% in Group 2a and 92% in Group 2b.

Conclusion: The ability to detect a wall motion abnormality immediately after exercise gives incremental diagnostic value to myocardial perfusion SPECT in the identification of mild, single-vessel CAD.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Aged
  • Case-Control Studies
  • Coronary Angiography
  • Coronary Artery Disease / diagnosis*
  • Electrocardiography
  • Exercise Test*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Ischemia / diagnosis*
  • Tomography, Emission-Computed, Single-Photon / methods
  • Tomography, Emission-Computed, Single-Photon / standards*
  • Ventricular Dysfunction, Left / diagnosis