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European Heart Journal 1992 13(2):213-219;
Copyright © 1992 by the European Society of Cardiology.
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© 1992 The European Society of Cardiology

Exercise echocardiography versus thallium-201 SPECT for assessing patients before and after PTCA

P. M. FIORETTI*,, M. M. A. POZZOLI*, B. ILMER*, A. SALUSTRI{ddagger}, J.-H. CORNEL*, A. E. M. REUS*, E. P. KRENNING{dagger}, J. H. C. REIBER*, P. J. DE FEYTER* and J. R. T. C. ROELANDT*

*Department of Cardiology, Thoraxcenter, Erasmus University and Academic Hospital Rotterdam-Dijkzigt Rotterdam, The Netherlands
{ddagger}Interuniversity Cardiology Institute The Netherlands, NL
{dagger}Department of Nuclear Medicine, Erasmus University and Academic Hospital Rotterdam-Dijkzigt Rotterdam, The Netherlands

Received 12 September 1990; revised 2 January 1991; .

Correspondence: Paolo M. Fioretti MD., Thoraxcenter, Ba 300, Erasmus University, P.O. Box 1738,3000 DR Rotterdam, The Netherlands.

Abstract

This study was designed (1) to assess the relationship between stress exercise echocardiography (echo) and201-Tlsingle photon emission computed tomography (SPECT) applied simultaneously in 23 patients who were candidates to percutaneous transluminal coronary angioplasty (PTCA), (2) to assess the relationship between the development of exerciseinduced wall motion abnormalities, transient perfusion defects and the severity of quantitatively assessed coronary stenoses and (3) to compare the functional improvement after PTCA by exercise echo and SPECT. Before PTCA there was an agreement of 78% between stress echo (new wall motion abnormalities) and SPECT (transient perfusion defects) results. All patients with a percentage diameter stenosis > 70% had a positive echo and SPECT, while they were both negative if the percentage diameter stenosis was < 50%. In 19 patients re-studied 4 weeks after PTCA, an ischaemic response at stress echo was found in two of the 13 patients who had a positive stress echo test before PTCA, and SPECT was still positive in three of the 10 patients who had a positive SPECT study before PTCA. Echo and SPECT were concordant in 17/19 cases. It is concluded that exercise echo and 201-Tl SPECT are useful non-invasive tools for the functional assessment of patients before andafter PTCA, and that they provide highly concordant results.

Key Words: Stress echocardiography • SPECT • PTCA


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