[The impact of the clinical data and the interhospital agreement in the interpretation of myocardial perfusion tomography]

Normal myocardial perfusion SPECT database for the Spanish population

INTRODUCTION AND OBJECTIVES

The aims of this study were to create a Spanish database of normal myocardial perfusion SPECT (single-photon emission computed tomography) data, termed the normal Spanish database, and to compare it with a database of normal data from the North American population.

METHODS

We selected 104 healthy volunteers (45 female, mean age 42+/-14 years) who underwent SPECT during stress and at rest. The findings were analyzed using the 4DM-SPECT commercial software package. The resulting normal Spanish database for males and females was compared with the North American population database (from 70 men and 60 women) provided with the 4DM-SPECT software.

RESULTS

In the Spanish database, the highest percentage uptake during both stress and rest was observed in medial-lateral region and the lowest, in the basal-septal region. The percentage uptake in the anterior-medial region was significantly lower in women than men, while uptake in the inferior, medial-septal and apical regions was lower in men than women. Data values in the Spanish database were significantly lower for the majority of heart regions than those in the database with the 4DM-SPECT software.

CONCLUSIONS

A Spanish database of normal myocardial perfusion SPECT data was created and included separate data for men and women. Significant differences were observed between this database and a commercial North American database that is commonly used in semiquantitative studies.

[Prognostic value of normal myocardial radionuclide scan in patients with positive treadmill test]

The purpose of this study was to determine the prognostic value of a normal 201Tl scan in patients with a positive treadmill exercise stress test. We analyzed retrospectively 85 consecutive patients with a positive treadmill exercise test and normal Tl201 scan who were studied for the diagnosis of coronary artery disease from January 1996 to December 2000. The pretest probability of coronary artery disease was intermediate or high in all patients. Seventy-eight patients (89%) were followed up for 2.03 years. Forty patients (51%) were men. Age was 56 years. The cardiac events considered were angina, revascularization, nonfatal myocardial infarction, and cardiac death. During the follow-up period, none of the patients suffered a major cardiac event. Eight patients had episodes of chest pain and one had angor that required revascularization. Patients with an intermediate probability of coronary artery disease before the test and normal myocardial radionuclide scan had a very good prognosis even with a positive treadmill exercise test.