Miyokard perfüzyon sintigrafisi, eforlu EKG ve koroner anjiografi sonuçlarinin karsilastirilmasi/Comparison of results of myocardial perfusion scintigraphy, effort stress testing and coronary angiography

ÖZET. Amaç: Koroner arter hastaligi tüm dünyada en sik görülen mortalite ve morbidite sebeplerinden birisidir. Koroner arterlerdeki aterosklerotik darligin kesin tanisinda koroner anjiografi kullanilmaktadir. Bu çalismada koroner arter hastaligi tanisinda kullanilan eforlu EKG ve miyokard perfüzyon sintigrafi ve koroner anjiografi bulgulari karsilasrtirildi. Gereç ve Yöntem: 101 hasta (47 erkek, 54 kadin; yas ortalamasi: 55 ± 10.95 yil) çalismaya alindi. Bu hastalara treadmill cihaziyla efor yaptirilarak 99m Tc-MIBI miyokard perfüzyon sintigrafisi çekildi. Bir ay içerisinde koroner anjiografi yapilan hastalar çalismaya dahil edildi. Bulgular: Efor testi pozitif olan hastalarin %55'i, süpheli olanlarin %82'si ve negatif olanlarin ise %29'unda koroner anjiografide darlik tespit edilirken miyokard perfüzyon sintigrafisinde iskemi gözlenen hastalarin %66'sinda ve normal degerlendirilen hastalarin %12'sinde darlik görüldü. Sonuç: Koroner arter darliginin tani ve takibinde efor testi ve miyokard perfüzyon sintigrafisi gibi noninvaziv testler kullanilmaktadir. Bu testlerin sonuçlari birlikte degerlendirildiginde koroner arter darligini göstermedeki dogruluklari artmaktadir. Anahtar kelimeler: Koroner arter hastaligi, miyokard iskemisi, miyokard perfüzyon sintigrafisi, koroner anjiografi, efor testi. ABSTRACT. Aim: Coronary artery disease is one of the most frequent causes of mortality and morbidity seen all over the world. In definite diagnosis of the atherosclerotic coronary artery stenosis, coronary angiography is used. In this study, additional contribution of the effort stress testing together with myocardial perfusion scintigraphy, which are noninvasive tests, to choose patients to coronary angiography. Materials and Methods: 101 patients (47 men, 54 women; mean age: 55 ± 10.95 year) were included into the study. In all patients 99m Tc-MIBI myocardial perfusion scintigraphy was performed following physiological effort on treadmill. Patients in whom coronary angiography were performed in 1 month before or after scintigraphic evaluation were included into the study. Results: In 55% of patients having positive effort stress testing, 82% of patients having suspicious and 29% of patients with negative test results atherosclerotic narrowing in coronary arteries were detected by angiography. Whereas, in 66% of patients had ischemic myocardial perfusion scintigraphic findings and 12% of patients with normal scintigraphy, angiography revealed coronary artery stenosis. Conclusion: In diagnosis and follow-up of coronary artery disease, effort stress testing and myocardial perfusion test are used. If findings of these tests are evaluated together, accuracy of the tests will be increased. Key words: coronary artery disease, myocardial ischemia, myocardial perfusion imaging, coronary angiography, exercise test.

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