Diagnostic and prognostic use of stress echocardiography and radionuclide scintigraphy

Stress echocardiography and radionuclide scintigraphy are effective diagnos tic and prognostic techniques in patients with known or suspected coronary artery disease (CAD), myocardial infarction (MI), chronic Left ventricular dysfunction (LVD), and those undergoing noncardiac surgery. Both are sensit ive and specific for the detection and extent of CAD. Negative tests confer a high negative predictive value for cardiac events irrespective of clinic al risk. Positive studies confer a high positive predictive value for ische mic events in patients with intermediate to high clinical risk. Both provid e incremental diagnostic and prognostic information relative to clinical, r esting echocardiographic, and angiographic data. Meta-analysis studies have shown that the diagnostic and prognostic information provided by stress ec hocardiography, is comparable with radionuclide scintigraphic stress tests. Stress echocardiography may be more specific for the detection and extent of CAD, whereas radionuclide scintigraphy may be more sensitive for single- vessel disease. Sensitivities are similar for the detection and extent of d isease in patients with multivessel CAD.