[Gated SPECT myocardial perfusion stress scintigraphy for evaluation of the ischemic risk in coronary artery disease].

The aim of study is to identify the sensitivity of gated SPECT myocardial perfusion stress scintigraphy (MPSS) for detection of multi - vessel coronary artery disease (MVD) and in the evaluation of their functional impact for ischemic risk determination. Thirty three patients were examined with Tc99m sestamibi MPSS in rest and after exercise in order to identify the involved vessel territories by the perfusion and kinetic stress abnormalities and the development of ischemic left ventricular (LV) dysfunction by the decrease in LV ejection fraction (LVEF) and by the transient LV dilation (TID). A semiquantitative evaluation of the perfusion abnormalities by the summed difference index (SDI) (according to 20- segments model in 5 degree scale) was done. All patients had coronary angiography in the previous 2-3 months. According to angiography MVD had 51% of patients. A good coincidence for the concrete abnormal vessel territories existed between angiography and MPSS. A good sensitivity and specificity of the perfusion abnormalities were found (87.94%). Lower sensitivity with better specificity were found for kinetic abnormalities. This way the combination between them was convenient for detection of attenuation artifacts. A stress included dysfunction represented by decrease in LVEF was found in 33 % of patients (91 % of them with MVD). TID was present in 30%. A significant difference between LVD and MVD patient existed in SDI values (2.5 +/- 2.87 versus 5.12 +/- 2.57,). CONCLUSION. Gated SPECT MPSS is with good sensitivity and specificity for MVD detection and convenient for evaluation of its functional impact and ischemic determination.