Abstract
Postexercise wall motion abnormality (WMA) in patients with normal resting myocardial
perfusion may represent prolonged postischemic stunning, and may be related to the
presence of severe angiographic coronary artery disease (CAD). This study assesses
the diagnostic value of postexercise WMA by technetium-99m (Tc-99m) sestamibi gated
single-photon emission computed tomography (SPECT) in patients with normal resting
perfusion. Ninety-nine patients underwent exercise gated Tc-99m sestamibi/resting
thallium-201 SPECT and coronary angiography within 90 days of nuclear testing. All
patients had normal perfusion at rest. Multivariate logistic regression analysis demonstrated
an incremental value of wall motion and perfusion over perfusion data alone in identifying
severe and extensive CAD. Sensitivity for identifying any severely stenosed coronary
artery by WMA was significantly higher than by severe perfusion defect (78% vs 49%,
p <0.0001). Overall specificities of severe perfusion defect and WMA were 91% and
85%, respectively (p = NS). Thus, postexercise WMA detected by gated Tc-99m sestamibi
SPECT in patients with normal resting perfusion is a sensitive marker of severe and
extensive CAD.
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Article info
Publication history
Published online: August 16, 2004
Accepted:
June 20,
2000
Received in revised form:
June 20,
2000
Received:
February 15,
2000
Identification
Copyright
© 2000 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
