Left Ventricle Anatomic Pattern Influence on Sensitivity, Specificity and Concordance on Myocardial Perfusion Studies

pp 623-629

Abstract

Objective

To evaluate the influence of the anatomical pattern of left ventricle (IV) on the sensitivity (Se), specificity (Sp), and concordance (C) in patients undergoing myocardial perfusion stress both by ergometry (ES) and by pharmacological test (PS) in the angiography (CCG).

Material and methods

Seventy-eight patients were studied, 52 males and 26 females, average age 64 ± 11 years old, all with different clinical ischemic cardiopathies, under ES and PS with non gated201T1SPECT. The ES underSAC protocol, the PS, 0.56 mg/kg/dose. Initially, bidimensional echocardiogram was analyzed in all cases, and according to the results patients were re-arranged in 3 groups. Group 1: normal IV anatomy(31 patients), Group 2: IV hypertrophy (LVH) (23patients) and Group 3: dilated myocardiopathy(DM) (24 patients). Everyone with CCG ±3 months after the reperfusion study. After both stress tests,Se, Sp and C were analyzed. We assessed C among the perfusion defects induced by both types of stress and the angiographic pattern in major epicardic vessels.

Results

                     Group 1             Group 2             Group3                                 ES      PS             ES    PS                ES    PS

Se (%)          94      87             90      91               76*  74*

Sp (%)          90      94              76*   85               71*  69*

C (%)             92     88              78*    80               72*  71*

* p < 0.05 Or less.

Conclusion

The presence of LVH and DM associated with obstructive coronary disease diminishes Sp (LVH), Se and Sp (DM), as well as concordance values be-tween perfusion defects and the anatomical localization of the responsible lesion.