Objectives
Myocardial perfusion scintigraphy (MPS) is a well-established method for diagnosis and managment of coronary artery disease (CAD). But equivocal results due to attenuation artifacts, technical or patient characteristics are limiting its value. Aortic elasticity impairs in parallel to degree of atherosclerosis. Aortic elasticity can be measured via aortic stiffness index and distensibility. The aim of this study was to examine the role of aortic elasticity for further evaluation in presence of different scintigraphic test results (normal scan, equivocal, and ischemia) among patients with suspect of CAD.
Methods
149 consecutive patients who had undergone both single-photon emission computed tomography MPS using 99mTc-sestamibi and transthoracic echocardiography were enrolled prospectively. Age, gender, height, weight, presence of cardiovascular risk factors were obtained. Aortic stiffness index and distensibility along with diastolic and systolic functions of the left ventricle were measured via echocardiography accordingly. The patients were enrolled into three groups according to MPS results (normal, equivocal, and ischemia).
Methods
149 consecutive patients who had undergone both single-photon emission computed tomography MPS using 99mTc-sestamibi and transthoracic echocardiography were enrolled prospectively. Age, gender, height, weight, presence of cardiovascular risk factors were obtained. Aortic stiffness index and distensibility along with diastolic and systolic functions of the left ventricle were measured via echocardiography accordingly. The patients were enrolled into three groups according to MPS results (normal, equivocal, and ischemia).
Results
The normal group was composed of 55 patients, the equivocal group included 54 patients, and the ischemia group was 40 patients. Average ages of the groups as well as gender distribution were similar (Table 1). Average aortic stiffness index values were 2.61±0.48 for the normal group; 2.60±0.49 for the equivocal group and 3.80±0.38 for the ischemia group. Aortic stiffness index value and diastolic dysfunction frequency of the equivocal group were similar to the normal group (p values >0.05) but significantly lower than the ischemia group (p values <0.001). Similar correlation was also obtained with aortic distensibility. Optimal threshold cut off point for aortic stiffness index to differentiate normal MPS result from MPS with ischemia in any left ventricle wall was calculated by ROC analysis. Aortic stiffness index value of 3.05 was found to be cut-off value with 98% sensitivity and 87% spesificity to detect ischemia (AUC:0.953 with 95% CI: 0.906 to 0.981 and p value<0,001)(Figure 1). If ASI value of >3.05 was accepted as abnormal, frequency of abnormal aortic stiffness index in the normal, equivocal, and ischemia groups were 11%, 19%, and 98% respectively. The equivocal group had similar frequency of abnormal aortic stiffness index compared to the normal group (p=0.262) while statistically lower number of abnormal aortic stiffness index than the ischemia group (p<0.001)
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
