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Titolo:
Impact of hypertension on the accuracy of exercise stress myocardial perfusion imaging for the diagnosis of coronary artery disease
Autore:
Elhendy, A; van Domburg, RT; Sozzi, FB; Poldermans, D; Bax, JJ; Roelandt, JRTC;
Indirizzi:
Mayo Clin & Mayo Fdn, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn Rochester MN USA 55905 Fdn, Rochester, MN 55905 USA Erasmus Univ, Hosp Dijkzigt, Thoraxctr, NL-3015 GD Rotterdam, Netherlands Erasmus Univ Rotterdam Netherlands NL-3015 GD GD Rotterdam, Netherlands
Titolo Testata:
HEART
fascicolo: 6, volume: 85, anno: 2001,
pagine: 655 - 661
SICI:
1355-6037(200106)85:6<655:IOHOTA>2.0.ZU;2-C
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR HYPERTROPHY; EMISSION COMPUTED-TOMOGRAPHY; TECHNETIUM 99M SESTAMIBI; SYSTEMIC HYPERTENSION; TC-99M TETROFOSMIN; FLOW RESERVE; SPECT; ANGIOGRAPHY; ECHOCARDIOGRAPHY; DIPYRIDAMOLE;
Keywords:
hypertension; coronary artery disease; exercise stress test; myocardial perfusion;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
36
Recensione:
Indirizzi per estratti:
Indirizzo: Elhendy, A Mayo Clin & Mayo Fdn, Plummer Bldg A1,200 1st St SW, Rochester,MN 55905 USA Mayo Clin & Mayo Fdn Plummer Bldg A1,200 1st St SW Rochester MN USA 55905
Citazione:
A. Elhendy et al., "Impact of hypertension on the accuracy of exercise stress myocardial perfusion imaging for the diagnosis of coronary artery disease", HEART, 85(6), 2001, pp. 655-661

Abstract

Aim - To compare the accuracy of exercise stress myocardial perfusion single photon emission computed tomography (SPECT) imaging for the diagnosis ofcoronary artery disease in patients with and without hypertension. Methods - A symptom limited bicycle exercise stress test in conjunction with 99m technetium sestamibi or tetrofosmin SPECT imaging was performed in 332 patients (mean (SD) age, 57 (10) years; 257 men, 75 women) without previous myocardial infarction who underwent coronary angiography. Of these, 137(41%) had hypertension. Rest SPECT images were acquired 24 hours after thestress test. An abnormal scan was defined as one with reversible or fixed perfusion defects. Results - In hypertensive patients, myocardial perfusion abnormalities were detected in 79 of 102 patients with significant coronary artery disease and in nine of 35 patients without. In normotensive patients, myocardial perfusion abnormalities were detected in 104 of 138 patients with significant coronary artery disease and in 16 of 57 patients without. There were no differences between normotensive and hypertensive patients in sensitivity (77%(95% confidence interval (CI) 69% to 86%) v 75% (95% CI 68% to 83%)), specificity (74% (95% CI 60% to 89%) v 72% (95% CI 60% to 84%)), and accuracy (77% (95% CI 70% to 84%) v 74% (95% CI 68% to 80%)) of exercise SPECT for diagnosing coronary artery disease. The accuracy of SPECT was greater than electrocardiography, both in hypertensive patients (p = 0.005) and in normotensive patients (p = 0.0001). For the detection of coronary artery disease in individual vessels, sensitivity was 58% (95% CI 51% to 65%) v 57% (95% CI51% to 64%), specificity was 86% (95% CI 82% to 90%) v 85% (95% CI 81% to 89%), and accuracy was 74% (95% CI 70% to 78%) v 74% (95% CI 70% to 78%) inpatients with and without hypertension (NS). Conclusions - In the usual clinical setting, the value of exercise myocardial perfusion scintigraghy for diagnosing coronary artery disease is not degraded by the presence of hypertension.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/06/19 alle ore 17:33:54