Myocardial perfusion SPECT and dobutamine stress tissue Doppler imaging in evaluation of patients with stable angina pectoris

Objective: To evaluate longitudinal function of ischemic and nonischemic myocardial tissue detected by Tc-99m MIBI single photon emission computed tomography (SPECT) prior to coronary revascularization in patients with stable angina pectoris. Methods: We studied 24 consecutive patients (mean age 62±9 years; 5 women) with stable angina pectoris. All patients underwent myocardial perfusion SPECT. Tissue Doppler imaging (TDI) was performed to detect myocardial systolic velocities of anterior, inferior, septum and lateral walls at rest and peak dobutamine stress. Results: A total of 96 segments were visualized with SPECT study. Maximum mean septal, lateral, anterior and inferior TDI systolic velocities were similar in ischemic and nonischemic segments (6.73±1.04 cm/sec, 6.93±1.34 cm/sec, respectively) at rest. At peak stress, maximum mean TDI systolic velocities were lower in the 37 ischemic segments (11.00±2.03 cm/sec) than 59 nonischemic segments (13.76±1.97cm/sec, p 0.001). Because we detected ischemia in whole group using both diagnostic tests, coronary angiography was decided. Critical coronary artery stenosis related to ischemic segments was detected and coronary revascularization decided. Conclusion: TDI with dobutamine stress can be used in patients with stable angina pectoris. In this study, we observed that quantitative data by TDI associated with SPECT showed an agreement for coronary revascularization.