Senior R, Sridhara B S, Anagnostou E, Handler C, Raftery E B, Lahiri A
Department of Cardiology, Northwick Park Hospital, Harrow, Middlesex, UK.
Am Heart J. 1994 Oct;128(4):713-8. doi: 10.1016/0002-8703(94)90269-0.
The relative value of exercise electrocardiography, simultaneous dobutamine technetium 99m-sestamibi (MIBI) single-photon-emission computerized tomography (SPECT), and echocardiography were evaluated for the diagnosis of coronary artery disease in patients with chest pain. Sixty-one consecutive patients underwent exercise electrocardiography and simultaneous graded dobutamine echocardiography and MIBI imaging. All patients underwent coronary arteriography. The exercise electrocardiogram was found to be a poor predictor of coronary artery disease (p not significant). Individually, MIBI SPECT and echocardiography were significantly predictive of coronary artery disease (p < 0.001). According to logistic regression analysis, the combined imaging modalities significantly increased the prediction of coronary artery disease for any vessel (p < 0.001), for multiple vessels (p < 0.001), and for the left anterior descending (p < 0.001), for right coronary artery (p < 0.001), and for left circumflex arteries (p < 0.01), compared with either MIBI SPECT or echocardiography alone. The results suggest a synergism in the detection of coronary artery disease when MIBI SPECT and echocardiography are combined during dobutamine stress.
对运动心电图、多巴酚丁胺负荷99m锝-甲氧基异丁基异腈（MIBI）单光子发射计算机断层扫描（SPECT）及超声心动图在胸痛患者冠状动脉疾病诊断中的相对价值进行了评估。61例连续患者接受了运动心电图检查、同步分级多巴酚丁胺超声心动图检查及MIBI成像检查。所有患者均接受了冠状动脉造影。结果发现运动心电图对冠状动脉疾病的预测能力较差（P值无统计学意义）。单独来看，MIBI SPECT和超声心动图对冠状动脉疾病有显著的预测价值（P<0.001）。根据逻辑回归分析，与单独使用MIBI SPECT或超声心动图相比，联合成像模式显著提高了对任何血管（P<0.001）、多支血管（P<0.001）、左前降支（P<0.001）、右冠状动脉（P<0.001）及左旋支动脉（P<0.01）冠状动脉疾病的预测能力。结果提示，在多巴酚丁胺负荷试验期间，将MIBI SPECT和超声心动图联合应用时，在检测冠状动脉疾病方面存在协同作用。
