DIAGNOSIS OF CORONARY-ARTERY DISEASE - VALUE AND LIMITATIONS OF NON-INVASIVE METHODS (ECG, THALLIUM PERFUSION SCINTIGRAPHY, RADIONUCLIDE ANGIOGRAPHY)

  • 1 January 1979
    • journal article
    • research article
    • Vol. 68  (11) , 748-753
Abstract
To compare the 3 non-invasive exercise tests ECG, Tl myocardial perfusion imaging and radionuclide angiography in the diagnosis of coronary artery disease, the results of these tests in a consecutive series of 30 patients and 14 controls were analyzed. In all 88 symptom-limited exercise tests a significantly higher double product (heart rate .times. systolic blood pressure, mmHg/min) was reached on a treadmill test (for ECG and Tl scintigraphy) compared to the supine bicycle ergometer exercise (for radionuclide angiography: 243.1 .+-. 61.1 vs. 215.2 .+-. 46.5 .times. 102 (P < 0.01)). Considering all 132 diagnostic tests the overall sensitivity for rest/exercise ECG was 67%, for Tl scans 77%, for both combined 83%, and for the ejection fraction response to exercise determined by radionuclide angiography 97%. If only the exercise response was considered, the corresponding sensitivity values were 60% (ECG), 47% (Tl scans), 70% (both tests combined) and 97% (radionuclide angiography). The specificity for coronary artery disease was determined to be 79% for ECG, 86% for Tl scintigraphy, 64% for ECG/Tl scans and 71% for radionuclide angiography. The most common reason for a false-positive result in all tests was the diagnosis of cardiomyopathy, whereas most false-negative results were seen in patients with single vessel right coronary artery disease. The clinical implications of the 3 non-invasive tests in the diagnosis of coronary artery disease are discussed.

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