|Title:||Enhanced Diagnosis of Coronary Artery Disease in Women by Dobutamine Thallium-201 St-Segment/Heart Rate Slope and Thallium-201 Myocardial Spect||Authors:||YEIH, DONG-FENG
|Keywords:||coronary artery disease;dobutamine;electrocardiograph;thallium scan;woman||Issue Date:||2007||Journal Volume:||v.106||Journal Issue:||n.10||Start page/Pages:||832-839||Source:||JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION||Abstract:||
Background/Purpose: The diagnosis of coronary artery disease (CAD) in women presents a great challenge because of poor exercise capacity and inadequate heart rate response during stress test. The clinical significance of stress-related ST- segment/heart rate slope (ST/HR slope) value for evaluating CAD in women remains controversial. Therefore, we conducted the present study to assess the diagnostic performance of dobutamine ST/HR slope in women, compared with myocardial perfusion study using thallium-201 single-photon emission computed tomography (Tl-201 SPECT). Methods: A total of 51 female patients with suspected CAD underwent simultaneous 12 -lead electrocardiographic recording during 3- minute stages of dobutamine infusion as well as Tl-201 SPECT, and coronary angiography was performed within 2 weeks post Tl-201 SPECT. The sensitivity, specificity positive predictive value and negative predictive value of dobutamine ST/HR slope and Tl- 201 SPELT were assessed, and the results of coronary angiography were used as a gold standard. Results: The sensitivity specificity and accuracy of dobutamine ST/HR slope in detecting CAD were 43%, 83% and 61%, and those of Tl-201 SPECT were 71%, 87% and 78%, respectively. However, using both positive results of Tl-201 SPECT and ST/HR slope for detecting CAD, the diagnostic specificity increased from 87% to 96%. Using both negative results of Tl-201 SPECT and ST/HR slope to exclude CAD, the negative predictive value increased from 71% to 85%. The accuracy of dobutamine ST/HR slope in detecting CAD was not affected by the use of beta- blockers. Conclusion: Dobutamine ST/HR slope is less sensitive and less accurate than Tl-201 SPECT for detecting CAD in women. However, it adds diagnostic benefit to Tl-201 SPECT with only a little extra calculation.
|Appears in Collections:||醫學系|
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