Salustri A, Pozzoli M M, Ilmer B, Hermans W, Reijs A E, Reiber J H, Roelandt J R, Fioretti P M
Thoraxcenter, Erasmus University Rotterdam, The Netherlands.
Int J Card Imaging. 1992;8(1):27-34. doi: 10.1007/BF01137563.
To compare the diagnostic value of exercise echocardiography and perfusion single photon emission computed tomography (SPECT) in the detection of the presence and the severity of coronary artery disease, we studied 21 patients with isolated stenosis of different degree of the left anterior descending artery. Both echocardiography and SPECT were performed in conjunction with the same symptom-limited bicycle exercise test. Positivity of the test was based on the presence of exercise-induced wall motion abnormalities and transient perfusion defects, respectively. For both tests, an 'ischemic' score was derived, as index of extent and severity of myocardial ischemia. Coronary arteriography was evaluated by caliper. The agreement between exercise echocardiography and SPECT for the presence of coronary artery disease was 90%; the discordance was due to two patients with positive echocardiography and negative SPECT. A good correlation between ischemic wall motion and perfusion score indices was found (r = 0.78, p less than 0.0001. Moreover, the percent diameter stenosis was well correlated with both ischemic indices (r = 0.75, p less than 0.0001; r = 0.67, p less than 0.001, respectively). In patients with a positive test, the mean value of ischemic wall motion score index was higher in patients with a diameter stenosis greater than or equal to 70% than in patients with a diameter stenosis less than 70% (0.59 +/- 0.19 vs 0.29 +/- 0.12, p less than 0.01); a similar trend was found for ischemic perfusion score index (0.51 +/- 0.35 vs 0.27 +/- 0.12, ns).(ABSTRACT TRUNCATED AT 250 WORDS)
为比较运动超声心动图和灌注单光子发射计算机断层扫描（SPECT）在检测冠状动脉疾病的存在及严重程度方面的诊断价值，我们研究了21例左前降支不同程度孤立狭窄的患者。超声心动图和SPECT均与相同的症状限制性自行车运动试验联合进行。试验阳性分别基于运动诱发的室壁运动异常和短暂灌注缺损的存在。对于这两种试验，均得出一个“缺血”评分，作为心肌缺血范围和严重程度的指标。通过卡尺评估冠状动脉造影。运动超声心动图和SPECT在冠状动脉疾病存在方面的一致性为90%；不一致是由于两名患者超声心动图阳性而SPECT阴性。发现缺血性室壁运动与灌注评分指标之间有良好的相关性（r = 0.78，p < 0.0001）。此外，直径狭窄百分比与两个缺血指标均有良好相关性（分别为r = 0.75，p < 0.0001；r = 0.67，p < 0.001）。在试验阳性的患者中，直径狭窄大于或等于70%的患者缺血性室壁运动评分指标的平均值高于直径狭窄小于70%的患者（0.59±0.19对0.29±0.12，p < 0.01）；缺血灌注评分指标也有类似趋势（0.51±0.35对0.27±0.12，无显著差异）。（摘要截于250字）
