Shaikh Ayaz Hussain, Hanif Bashir, Hassan Khursheed
Tabba Heart Institute, Karachi.
J Pak Med Assoc. 2011 Aug;61(8):723-6.
To determine the correlation of Duke treadmill score (DTS) with gated single photon emission computed tomography-myocardial perfusion imaging (SPECT-MPI) in patients evaluated for chest pain.
A retrospective study was conducted at Tabba Heart institute. Two hundred consecutive patients, referred to the nuclear cardiology laboratory for evaluation of chest pain by using stress myocardial perfusion imaging (MPI) from January 2008 to August 2008 were included. Duke Treadmill Score (DTS) was calculated after exercise testing and categorized as low, moderate and high DTS groups. Subsequent gated SPECT-MPI was performed and stratified according to severity of perfusion defect. Spearmans rho (non parametric test) was applied to determine the correlation between DTS and SPECT-MPI RESULTS: The overall result showed positive linear correlation between DTS and MPI (p = < 0.001). Out of 200 patients, 136 (68%) had low DTS, 51 (25.5%) had moderate and 13 (6.5%) had high DTS respectively. In low DTS group 129 (95%) patients had low risk MPI and 7 (5%) had intermediate risk MPI. In moderate risk DTS group 25 (49%) had low risk MPI whereas 15 (29.5%) and 11 (21.5%) had intermediate and high risk MPI respectively. In high DTS group all 13 patients had high risk MPI.
On the basis of our findings it can be hypothesized that patients with high DTS can be referred for coronary angiography without imaging and patients with low DTS can be followed on medical management. However for definite conclusion diagnostic accuracy needs to be determine in further studies.
确定在因胸痛接受评估的患者中,杜克运动平板评分(DTS)与门控单光子发射计算机断层扫描心肌灌注成像(SPECT-MPI)之间的相关性。
在塔巴心脏病研究所进行了一项回顾性研究。纳入了2008年1月至2008年8月连续200例因胸痛被转诊至核心脏病学实验室进行负荷心肌灌注成像(MPI)评估的患者。运动试验后计算杜克运动平板评分(DTS),并分为低、中、高DTS组。随后进行门控SPECT-MPI,并根据灌注缺损的严重程度进行分层。应用斯皮尔曼等级相关系数(非参数检验)来确定DTS与SPECT-MPI之间的相关性。结果:总体结果显示DTS与MPI之间呈正线性相关(p = <0.001)。200例患者中,分别有136例(68%)DTS低,51例(25.5%)DTS中等,13例(6.5%)DTS高。在低DTS组中,129例(95%)患者MPI风险低,7例(5%)患者MPI风险中等。在中度风险DTS组中,25例(49%)患者MPI风险低,而15例(29.5%)和11例(21.5%)患者MPI风险中等和高。在高DTS组中,所有13例患者MPI风险高。
根据我们的研究结果可以推测,DTS高的患者可直接进行冠状动脉造影而无需影像学检查,DTS低的患者可进行药物治疗随访。然而,要得出确切结论,还需要在进一步研究中确定诊断准确性。