Exercise electrocardiogram combined with cadmium zinc tellurium (CZT) cardiac-dedicated single photon emission computed tomography (SPECT) predicts coronary artery disease.

AIM

Coronary artery disease (CAD) is a primary cause of mortality, prompting ongoing research into noninvasive diagnostic modalities. This study aimed to evaluate the diagnostic efficacy of exercise electrocardiography testing (EET) combined with cadmium zinc tellurium cardiac-dedicated single photon emission computed tomography (CZT-SPECT) imaging for CAD.

MATERIALS AND METHODS

CZT-SPECT and EET were examined in 124 patients aged 20-85 years, followed by coronary angiography to evaluate the sensitivity, specificity, positive predictive value, and negative predictive value of EET/CZT-SPECT alone and in combination. CAD was defined as the presence of > 50% stenosis at the time of coronary angiography.

RESULTS

The sensitivity of the EET test alone was 31.58%, the specificity was 80%, the positive predictive value (PPV) was 22.22%, and the negative predictive value (NPV) was 86.6%. The corresponding values of CZT-SPECT alone were 36.07%, 92.06%, 81.48% and 59.79%, respectively. The combined results showed that the sensitivity, specificity, PPV, and NPV were 60.00%, 90.57%, 54.55%, and 92.31%, respectively. In this study, the positive likelihood ratio (PLR) diagnosed with EET alone was 1.58, the PLR diagnosed with CZT-SPECT alone was 4.54, and the PLR diagnosed with combination was 6.36.

CONCLUSION

The combination of CZT-SPECT and EET showed significantly improved CAD diagnostic accuracy compared with either approach alone.