Why the study?
To determine whether regional wall motion abnormalities on rest-only 99mTc-MIBI ECG-gated SPECT MPI provide incremental diagnostic value for detecting obstructive CAD in patients with suspected CAD.
Does the combination of perfusion and regional wall motion abnormalities by rest-only ECG-gated SPECT MPI improve the detection of obstructive CAD compared to perfusion alone in suspected CAD patients?
Does the combination of perfusion and regional wall motion abnormalities by rest-only ECG-gated SPECT MPI improve the detection of obstructive CAD compared to perfusion alone in suspected CAD patients?
Adding regional wall motion assessment to rest-only SPECT MPI significantly improves sensitivity for detecting obstructive CAD without compromising specificity.
May enhance obstructive CAD detection on rest-only SPECT MPI; leaves open need for prospective outcome trials before practice change.
OBJECTIVE: The purpose of this study was to determine whether regional wall motion (WM) abnormalities by rest-only 99mtechnetium-sestamibi (99mTc-MIBI) electrocardiogram (ECG)-gated single-photon emission computerized tomography (SPECT) myocardial perfusion imaging (MPI) had incremental diagnostic value for detecting obstructive coronary artery disease (CAD) in suspected CAD patients. METHODS: This study retrospectively studied 255 consecutive suspected CAD patients who underwent rest-only ECG-gated SPECT MPI and were performed coronary angiography within 3 months. Obstructive CAD was defined as ≥70% narrowing of the inner diameter of the left anterior descending coronary artery, left circumflex coronary artery and right coronary artery or their main branches and ≥50% narrowing of the left main coronary artery. QPS and QGS were used to assess rest perfusion and WM. Summed rest score ≥4 and summed motion score ≥2 exhibited in two consecutive segments in one territory was considered abnormal. RESULTS: The sensitivity of the combination of perfusion and regional WM abnormalities was significantly higher than perfusion alone for detecting obstructive CAD (46.8% vs. 30.9%; P < 0.001), with similar specificity (91.9% vs. 95.0; P = 0.063). The global chi-square value of combination of perfusion and WM increased from 31.40 to 50.71 (P < 0.001) compared to perfusion. The sensitivity of combination of perfusion and WM for detecting obstructive CAD in patients with multivessel disease was higher than single-vessel disease (56.1% vs. 25.0%; P < 0.001), with similar specificity. CONCLUSION: Regional WM abnormalities at rest, as shown by rest-only 99mTc-MIBI ECG-gated SPECT MPI, have additional diagnostic value over perfusion alone for detecting obstructive CAD in suspected CAD patients.
No takes yet. Share an insight, caveat, or question.
Liu et al. (2020) studied this question.
Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context: