COMPARISON BETWEEN DOBUTAMINE STRESS ECHOCARDIOGRAPHY AND MYOCARDIAL PERFUSIONM IMAGING IN DETECTION OF CORONARY ARTERY DISEASE

Abstract

Objective: To compare the validity of both myocardial perfusion imaging (MPI)
and 2-dimensional echocardiography for identification of patients with coronary
artery.
Methodology: This was hospital based observational study, conducted in
Cardiology department, Lady Reading Hospital, Peshawar, from May 2008 to Jun
2009. Total number of patients were 50 in number (Non probability purposive
sampling.)
Results: Total of 50 patients, whose mean age was 53.8±9.7, were studied. Men
were 35 (70%) and women were 15 (30%). Myocardial perfusion imaging was
reported as normal in 5(10%) patients while 45 (90%) had abnormal results.
Dobutamine stress echo was interpreted as normal in 8 patients (14%), wall
motion abnormality was noted in 42 patients (86%). Coronary angiography
showed 44 patients (88%) had > 50% stenosis in at least one coronary artery.
Compared with coronary angiography, the sensitivity, specificity, positive
predictive value and negative predictive values of myocardial perfusion imaging
for detection of CAD were 98%, 67%, 95%, and 80% respectively. The sensitivity
for LAD, RCA, and CIRC were 89.7%, 94.7% and 72.2% respectively. The overall
sensitivity, specificity, positive predictive value and negative predictive values of
dobutamine stress echo were 93%, 83%, 98%, and 63% respectively while for
LAD, RCA, CIRC the sensitivities were 84.6%, 73.3%, 72.2% respectively.
Conclusion: Both myocardial perfusion imaging (MPI) and Dobutamine Stress
Echocardiography has a high sensitivity for identifying patients with coronary
artery disease. Myocardial perfusion imaging is more sensitive than stress echo
while the specificity of stress echocardiography is high in detection of CAD.