Revista médica de Chile
versión impresa ISSN 0034-9887
PENA Q, Yamilé et al. Gated single photon emission computer tomography for the detection of silent myocardial ischemia. Rev. méd. Chile [online]. 2009, vol.137, n.8, pp. 1023-1030. ISSN 0034-9887. http://dx.doi.org/10.4067/S0034-98872009000800004.
Background: Asymptomatic patients with severe coronary atherosclerosis may have a normal resting electrocardiogram and stress test. Aim: To assess the yield of Gated Single Photon Emission Computer Tomography (SPECT) for the screening of silent myocardial ischemia in type 2 diabetic patients. Material and methods: Electrocardiogram, stress test and gated-SPECT were performed on 102 type 2 diabetic patients aged 60 ± 8 years without cardiovascular symptoms. AH subjects were also subjected to a coronary angiography whose results were used as gold standard. Results: Gated-SPECT showed myocardial ischemia on 26.5% of studied patients. The sensibility, specifity accuracy, positive predictive value and negative predictive value were 92.3%, 96%, 95%, 88.8%, 97.3%, respectively. In four and six patients ischemia was detected on resting electrocardiogram and stress test, respectively. Eighty percent of patients with doubtful resting electrocardiogram results and 70% with a doubtful stress test had a silent myocardial ischemia detected by gated-SPECT There was a good agreement between the results of gated-SPECT and coronary angiography (k =0.873). Conclusions: Gated-SPECT was an useful tool for the screening of silent myocardial ischemia.
Palabras clave : Diabetes mellitus; type 2; Myocardial ischemia; Tomography; emission-computed; single-photon.