The role of myocardial perfusion imaging in the identification of the obstructive coronary artery lesions: a tertiary cardiology center experience

Abstract

Objectives: Because of the moderate accuracy of treadmill electrocardiogram and fear of a claim if a diagnosisis missed, cardiologists usually order Myocardial Perfusion Imaging (MPI) as a first-step test in most of patientswith chest pain admitted to cardiology department. The performance of the MPI in diagnosing obstructiveCAD depends on the population studied. Thus we aimed to assess the agreement between MPI and coronaryangiography in the identification of the obstructive coronary lesion.Methods: A total of 231 patients who underwent MPI due to suspicion of coronary ischemia and had a coronaryangiogram within the last three months were included in this retrospective study. MPI and coronary angiographyfindings were analyzed to weigh the performance of MPI in determining obstructive coronary lesion.Results: The mean age was 63.9 ± 8.9 years, 54.5 % being males. MPI showed a sensitivity of 0.86 indetermining patients who had a significant (> 70%) coronary lesion. While evaluating the ability of MPI todetect ischemia in the left ventricle region which is supplied by the lesioned vessel, the sensitivity was foundto be; 60% in determining anterior ischemia associated with significant LAD lesion, 77.4% in determininginferior ischemia associated with significant RCA lesion, and 44.4% in determining lateral ischemia associatedwith significant CX lesion.Conclusions: Our findings have shown that MPI with visual assessment has 86% sensitivity for detectingsignificant coronary artery stenosis. However, the sensitivity of MPI in determining ischemia in the left ventricleregion which is supplied by the lesioned coronary artery was found to be 44.4 to 77.4%.