Dobutamine technetium-99m tetrofosmin SPECT imaging for the imaging for the diagnosis of coronary artery disease in patients with limited exercise capacity

Abdou Elhendy, Fabiola B. Sozzi, Roelf Valkema, Ron T. Van Domburg, Jeroen J. Bax, Jos R T C Roelandt

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background. Technetium-99m tetrofosmin single photon emission computed tomography (SPECT) imaging is increasingly used in conjunction with exercise and vasodilator stress test as a means of evaluating coronary artery disease (CAD). Dobutamine stress test is an alternative in patients with limited exercise capacity. This study assessed the accuracy of dobutamine-atropine stress tetrofosmin SPECT as a means of diagnosing and localizing CAD. Methods and Results. We studied 124 patients (mean age, 57 ± 12 years; 88 men) with limited exercise capacity and suspected CAD with dobutamine (as much as 40 μg/kg/min)-atropine (as much as 1 mg) Tc-99m tetrofosmin SPECT. Resting images were acquired 24 hours after the stress test. Significant CAD was defined as 50% or greater luminal diameter stenosis in 1 or more major coronary arteries. Myocardial perfusion abnormalities (fixed and/or reversible defects) were detected in 70 of 88 patients with CAD and in 10 of the 36 patients without CAD (sensitivity = 80%, CI, 72 to 87; specificity = 72%, CI, 64 to 80; accuracy = 77%, CI, 70 to 85). Sensitivity and accuracy rates were higher by using the criterion of any defect than by using the criterion of reversible defects only (80% vs 51%, P <.0001; 77% vs 60%, P <.01, respectively). The sensitivity rate was higher in patients with multivessel CAD than in patients with single-vessel CAD (88% vs 63%, P <.05). Patients with multivessel CAD had a larger stress perfusion defect score (4.5 ± 3.1 vs 2.7 ± 2.5, P <.01) than patients with single-vessel CAD. Conclusion. Dobutamine stress Tc-99m tetrofosmin SPECT is a useful method for the diagnosis and localization of CAD in patients with limited exercise capacity. Optimal accuracy of the technique is achieved by using both fixed and reversible perfusion abnormalities for the diagnosis of CAD in patients without an earlier myocardial infarction.

Original languageEnglish
Pages (from-to)649-654
Number of pages6
JournalJournal of Nuclear Cardiology
Volume7
Issue number6
DOIs
Publication statusPublished - 2000

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Dobutamine
Single-Photon Emission-Computed Tomography
Coronary Artery Disease
Exercise
Exercise Test
Perfusion
Atropine
technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane
Vasodilator Agents
Coronary Vessels
Pathologic Constriction
Myocardial Infarction

Keywords

  • Coronary artery disease
  • Dobutamine stress test
  • Tetrofosmin single photon emission computed tomography imaging

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Dobutamine technetium-99m tetrofosmin SPECT imaging for the imaging for the diagnosis of coronary artery disease in patients with limited exercise capacity. / Elhendy, Abdou; Sozzi, Fabiola B.; Valkema, Roelf; Van Domburg, Ron T.; Bax, Jeroen J.; Roelandt, Jos R T C.

In: Journal of Nuclear Cardiology, Vol. 7, No. 6, 2000, p. 649-654.

Research output: Contribution to journalArticle

Elhendy, Abdou ; Sozzi, Fabiola B. ; Valkema, Roelf ; Van Domburg, Ron T. ; Bax, Jeroen J. ; Roelandt, Jos R T C. / Dobutamine technetium-99m tetrofosmin SPECT imaging for the imaging for the diagnosis of coronary artery disease in patients with limited exercise capacity. In: Journal of Nuclear Cardiology. 2000 ; Vol. 7, No. 6. pp. 649-654.
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title = "Dobutamine technetium-99m tetrofosmin SPECT imaging for the imaging for the diagnosis of coronary artery disease in patients with limited exercise capacity",
abstract = "Background. Technetium-99m tetrofosmin single photon emission computed tomography (SPECT) imaging is increasingly used in conjunction with exercise and vasodilator stress test as a means of evaluating coronary artery disease (CAD). Dobutamine stress test is an alternative in patients with limited exercise capacity. This study assessed the accuracy of dobutamine-atropine stress tetrofosmin SPECT as a means of diagnosing and localizing CAD. Methods and Results. We studied 124 patients (mean age, 57 ± 12 years; 88 men) with limited exercise capacity and suspected CAD with dobutamine (as much as 40 μg/kg/min)-atropine (as much as 1 mg) Tc-99m tetrofosmin SPECT. Resting images were acquired 24 hours after the stress test. Significant CAD was defined as 50{\%} or greater luminal diameter stenosis in 1 or more major coronary arteries. Myocardial perfusion abnormalities (fixed and/or reversible defects) were detected in 70 of 88 patients with CAD and in 10 of the 36 patients without CAD (sensitivity = 80{\%}, CI, 72 to 87; specificity = 72{\%}, CI, 64 to 80; accuracy = 77{\%}, CI, 70 to 85). Sensitivity and accuracy rates were higher by using the criterion of any defect than by using the criterion of reversible defects only (80{\%} vs 51{\%}, P <.0001; 77{\%} vs 60{\%}, P <.01, respectively). The sensitivity rate was higher in patients with multivessel CAD than in patients with single-vessel CAD (88{\%} vs 63{\%}, P <.05). Patients with multivessel CAD had a larger stress perfusion defect score (4.5 ± 3.1 vs 2.7 ± 2.5, P <.01) than patients with single-vessel CAD. Conclusion. Dobutamine stress Tc-99m tetrofosmin SPECT is a useful method for the diagnosis and localization of CAD in patients with limited exercise capacity. Optimal accuracy of the technique is achieved by using both fixed and reversible perfusion abnormalities for the diagnosis of CAD in patients without an earlier myocardial infarction.",
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T1 - Dobutamine technetium-99m tetrofosmin SPECT imaging for the imaging for the diagnosis of coronary artery disease in patients with limited exercise capacity

AU - Elhendy, Abdou

AU - Sozzi, Fabiola B.

AU - Valkema, Roelf

AU - Van Domburg, Ron T.

AU - Bax, Jeroen J.

AU - Roelandt, Jos R T C

PY - 2000

Y1 - 2000

N2 - Background. Technetium-99m tetrofosmin single photon emission computed tomography (SPECT) imaging is increasingly used in conjunction with exercise and vasodilator stress test as a means of evaluating coronary artery disease (CAD). Dobutamine stress test is an alternative in patients with limited exercise capacity. This study assessed the accuracy of dobutamine-atropine stress tetrofosmin SPECT as a means of diagnosing and localizing CAD. Methods and Results. We studied 124 patients (mean age, 57 ± 12 years; 88 men) with limited exercise capacity and suspected CAD with dobutamine (as much as 40 μg/kg/min)-atropine (as much as 1 mg) Tc-99m tetrofosmin SPECT. Resting images were acquired 24 hours after the stress test. Significant CAD was defined as 50% or greater luminal diameter stenosis in 1 or more major coronary arteries. Myocardial perfusion abnormalities (fixed and/or reversible defects) were detected in 70 of 88 patients with CAD and in 10 of the 36 patients without CAD (sensitivity = 80%, CI, 72 to 87; specificity = 72%, CI, 64 to 80; accuracy = 77%, CI, 70 to 85). Sensitivity and accuracy rates were higher by using the criterion of any defect than by using the criterion of reversible defects only (80% vs 51%, P <.0001; 77% vs 60%, P <.01, respectively). The sensitivity rate was higher in patients with multivessel CAD than in patients with single-vessel CAD (88% vs 63%, P <.05). Patients with multivessel CAD had a larger stress perfusion defect score (4.5 ± 3.1 vs 2.7 ± 2.5, P <.01) than patients with single-vessel CAD. Conclusion. Dobutamine stress Tc-99m tetrofosmin SPECT is a useful method for the diagnosis and localization of CAD in patients with limited exercise capacity. Optimal accuracy of the technique is achieved by using both fixed and reversible perfusion abnormalities for the diagnosis of CAD in patients without an earlier myocardial infarction.

AB - Background. Technetium-99m tetrofosmin single photon emission computed tomography (SPECT) imaging is increasingly used in conjunction with exercise and vasodilator stress test as a means of evaluating coronary artery disease (CAD). Dobutamine stress test is an alternative in patients with limited exercise capacity. This study assessed the accuracy of dobutamine-atropine stress tetrofosmin SPECT as a means of diagnosing and localizing CAD. Methods and Results. We studied 124 patients (mean age, 57 ± 12 years; 88 men) with limited exercise capacity and suspected CAD with dobutamine (as much as 40 μg/kg/min)-atropine (as much as 1 mg) Tc-99m tetrofosmin SPECT. Resting images were acquired 24 hours after the stress test. Significant CAD was defined as 50% or greater luminal diameter stenosis in 1 or more major coronary arteries. Myocardial perfusion abnormalities (fixed and/or reversible defects) were detected in 70 of 88 patients with CAD and in 10 of the 36 patients without CAD (sensitivity = 80%, CI, 72 to 87; specificity = 72%, CI, 64 to 80; accuracy = 77%, CI, 70 to 85). Sensitivity and accuracy rates were higher by using the criterion of any defect than by using the criterion of reversible defects only (80% vs 51%, P <.0001; 77% vs 60%, P <.01, respectively). The sensitivity rate was higher in patients with multivessel CAD than in patients with single-vessel CAD (88% vs 63%, P <.05). Patients with multivessel CAD had a larger stress perfusion defect score (4.5 ± 3.1 vs 2.7 ± 2.5, P <.01) than patients with single-vessel CAD. Conclusion. Dobutamine stress Tc-99m tetrofosmin SPECT is a useful method for the diagnosis and localization of CAD in patients with limited exercise capacity. Optimal accuracy of the technique is achieved by using both fixed and reversible perfusion abnormalities for the diagnosis of CAD in patients without an earlier myocardial infarction.

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