SIMULTANEOUS DOBUTAMINE STRESS ECHOCARDIOGRAPHY AND DOBUTAMINE SCINTIGRAPHY (TC-99M-MIBI-SPET) FOR ASSESSMENT OF CORONARY-ARTERY DISEASE

Background: Simultaneous dobutamine stress echocardiography (DSE) and Tc-99m-MIBI-SPET (DMS) for the evaluation of the presence and the exte nt of coronary artery disease (CAD) were assessed for a head to head c omparison 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 simultaneo us dobutamine stress echocardiography and MIBI-SPET imaging. Coronary angiography was performed in all patients (significant coronary stenos is >50%). On the basis of the results of exercise electrocardiogram th e pre-test probability for coronary artery disease (Diamond's algorith m) was low (45.6 +/- 12.7 %). The overall specificity, sensitivity and predictive accuracy of Echo-dobutamine stress test for diagnosis of t he presence or absence of CAD were: specificity 82%, sensitivity 76%, diagnostic accuracy 80%, positive predictive value 90%, negative predi ctive value 40%. The overall specificity, sensitivity and predictive a ccuracy of MIBI-SPET-dobutamine test for diagnosis of the presence or absence of CAD were: specificity 86%, sensitivity 87%, diagnostic accu racy 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 non invasive methods for the detection of CAD showed a good diagnostic acc uracy. Nevertheless the SPET model showed an higher sensitivity in com parison with DSE model, essentially in the presence of a lower extent of CAD and during submaximal test.