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.