[Simultaneous assessment of exercise-induced abnormalities in myocardial perfusion and regional wall motion by using...

To clarify the usefulness of the combined assessment of exercise (EX)-induced abnormalities in myocardial perfusion and regional wall motion for detecting coronary artery disease (CAD), we carried out first-pass radionuclide angiography and myocardial perfusion imaging during EX and at rest by 99mTc-tetrofosmin. Twenty-four patients with angiographically proven CAD, 9 (Gp A) with single and 15 (Gp B) with multivessel disease, were studied. The sensitivity for the detection of CAD was 78% of Gp A, 73% of Gp B in planar image and 78%, 87% in SPECT image, respectively. When left ventricular ejection fraction and regional ejection fraction (rEF) were combined with the result of myocardial perfusion, sensitivity increased up to 89% of Gp A, 100% of Gp B. Diagnostic accuracy of LAD, LCX and RCA was 79%, 88% and 83%, respectively. Regional EF in ischemic areas decreased during EX in both Gps, particularly in Gp B. Regional EF in relatively normal perfusion areas did not significantly change in Gp A, but decreased in Gp B. These results suggest that 99mTc-tetrofosmin contributes to the improvement of sensitivity for CAD by combined assessment of EX-induced wall motion and myocardial perfusion abnormalities.