Korean J Med.  2001 Feb;60(2):106-114.

Early dipyridamole stress myocardial SPECT to detect residual stenosis of infarct related artery: comparison with coronary angiography and fractional flow reserve

• Seo JK
• Kwan J
• Kim DH
• Yang SS
• Lee KH
• Hyun IY
• Choe W
• Lee HJ
• Park KS
• Lee WH

Abstract

BACKGROUND: The detection of residual stenosis of infarct related artery (IRA) at early stage after acute myocardial infarction (AMI) is crucial in clinical decision making for interventional revascularization. The aim of this study was to evaluate the relevancy of early dipyridamole stress myocardial SPECT to detect functionally and luminologically significant residual stenosis of IRA after AMI.
METHODS
Twenty five consecutive patients (M:F=19:6, age: 56+/-13yrs) with AMI were underwent SPECT and coronary angiography within 5 days of the attack. Infarct related arteries with FFR 70% were regarded to have functionally and morphologically significant residual stenosis. Reversible perfusion defect was defined if there was improvement of pefusion score more than one grade in infarct segments on rest images of SPECT compared with stress images.
RESULTS
Mean FFR and DST were 0.76+/-0.14 and 74+/-15%. SPECT showed no significant correlation with both FFR and DST with Kendall's coefficiency of 0.28 (p=0.05) and 0.13 (p=0.35). The sensitivity and specificity of SPECT to detect functionally and morphologically significant residual stenosis were 92%, 31% and 83%, 29%.
CONCLUSION
The early dipyridamole stress myocardial SPECT after AMI dose not seem to be a useful non-invasive test for the detection of functionally and luminologically significant residual stenosis of IRA.

Keyword

Myocardial infarction; Dipyridamole; Tomography; Emission-computed; Single-photon

MeSH Terms

Arteries*
Constriction, Pathologic*
Coronary Angiography*
Decision Making
Dipyridamole*
Humans
Myocardial Infarction
Perfusion
Sensitivity and Specificity
Tomography, Emission-Computed, Single-Photon*
Dipyridamole