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Simultaneous dobutamine stress echocardiography and dobutamine scintigraphy (99mTc-MIBI-SPET) for assessment of coronary artery disease

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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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Authors and Affiliations

  1. 2nd Institute of Clinical Medicine and Nuclear Medicine Centre, University of Pisa, Italy

    V. Di Bello M.D., 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

  2. Division of Cardiovascular Medicine, Hospital of Pisa, Italy

    E. Magagnini

  3. Department of Statistics and Mathematics Applied to Economics, University of Pisa, Italy

    M. F. Romano

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  1. V. Di Bello M.D.
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  2. C. Riccardo Bellina
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  3. N. Molea
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  4. L. Talarico
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  5. G. Boni
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  6. E. Magagnini
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  7. F. Matteucci
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  8. D. Giorgi
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  9. E. Lazzeri
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  10. A. Bertini
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  11. M. F. Romano
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  12. R. Bianchi
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  13. C. Giusti
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Di Bello, V., Riccardo Bellina, C., Molea, N. et al. Simultaneous dobutamine stress echocardiography and dobutamine scintigraphy (99mTc-MIBI-SPET) for assessment of coronary artery disease. Int J Cardiac Imag 12, 185–190 (1996). https://doi.org/10.1007/BF01806221

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  • DOI: https://doi.org/10.1007/BF01806221

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