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[Usefulness of stress scintigraphy on screening coronary artery disease in peripheral vascular patients]
1Cardiovascular Department of Internal Medicine, National Cardiovascular Center.
Insights
Stress scintigraphy (SSG) effectively screens for coronary artery disease in peripheral vascular patients. This non-invasive method shows high sensitivity, aiding surgical decisions for patients with atherosclerosis (ASO).
Area of Science:
- Cardiology
- Nuclear Medicine
- Vascular Surgery
Background:
- Coronary artery disease (CAD) frequently complicates peripheral vascular disease, specifically Atherosclerosis (ASO).
- A non-invasive screening tool is crucial for determining surgical indications in these patients.
- Current methods may be limited by patient exercise capacity.
Purpose of the Study:
- To evaluate the utility of stress scintigraphy (SSG) using a bicycle ergometer for detecting coronary artery disease (CAD) in patients with peripheral vascular disease (ASO).
Main Methods:
- Forty-nine patients with suspected CAD underwent bicycle ergometer stress scintigraphy (SSG).
- Coronary arteriography (CAG) was performed on 27 patients for comparison.
- Exercise capacity and redistribution patterns on SSG were analyzed.
Main Results:
- SSG identified redistribution in 39 out of 49 patients.
- CAG revealed significant coronary artery stenosis in 26 out of 27 patients.
- Despite leg pain limiting exercise in 23 patients, SSG demonstrated 83% sensitivity for significant stenosis in a subgroup (10/12 patients).
Conclusions:
- Stress scintigraphy (SSG) using a bicycle ergometer is a valuable non-invasive screening method for detecting coronary artery disease (CAD) in peripheral vascular patients (ASO).
- SSG exhibits high sensitivity even when exercise is limited by leg pain, supporting its clinical utility.
Abstract:
Coronary artery disease is an important and frequent complication of peripheral vascular patients (ASO). Therefore a non-invasive screening method is needed to decide the surgical indication for peripheral vascular patients. We studied the usefulness of stress scintigraphy (SSG) by using a bicycle ergometer. Forty-nine patients with chest pain or ECG abnormality were subjected to this study. Twenty-seven patients had coronary arteriography (CAG) performed on them. The redistribution image was noted 39 of the 49 patients who actually performed SSG. CAG was performed on 27 patients, and significant stenosis of the coronary artery was noted in 26 of them. Twenty-three of the 49 patients stopped exercising due to leg pain, but 10 out of 12 patients were noted in the redistribution image in 201Tl scintigraphy to have significant stenosis (sensitivity 83%). It is reported that SSG using a bicycle ergometer can detect ischemia with less stress than when a treadmill exercise test is used. In this study, 23 out of 49 patients stopped exercising due to leg pain but a high sensitivity of 83% was noted in these patients. This sensitivity was thought to be evidence enough to detect coronary artery disease in peripheral vascular patients. In summary, SSG is a useful screening method to detect coronary artery disease in peripheral vascular patients (ASO).