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European Heart Journal 1992 13(5):646-654;
Copyright © 1992 by the European Society of Cardiology.
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© 1992 The European Society of Cardiology

Evaluation of changes in myocardial function on exercise in patients with coronary artery disease using gated MIBI scintigraphy

P. G. AVERY, H. WILLIAMS, M. Y. EARLY, N. M. HUDSON and P. J. B. HUBNER

Regional Cardiothoracic Unit, Groby Road Hospital Groby Road, Leicester

Received 22 February 1991; revised 5 June 1991; .

Correspondence. Dr P. G. Avery, Department of Cardiology, University Hospital of Wales, Heath Park, Cardiff CF4 4XN, Wales, U.K.

Abstract

Technetium-99m-methoxy-isobutyl-isonitrile (MIBI) is a myocardial perfusion agent which allows simultaneous assessment of left ventricular function. We evaluated left ventricular (LV) function with exercise using a new method of myocardial profiling in 43 patients with chest pain. Twenty-eight had significant coronary artery disease and 15 were normal on coronary angiography. Results were compared to equilibrium radionuclide ventriculography.

MIBI fractional shortening (FS) correlated well with ejection fraction (EF) onexercise (r = 0.79, P= <0.001). There was also a good correlation between changes in global function from rest to exercise (r = 0.82, P= <0.001) with a sensitivity of diagnosing CAD of 71% and specificity of 80%. New regional wall abnormalities were detected in 25/28 with CAD with a sensitivity of 89% and specificity of 60%. There was also a close correlation between mean diameters measured with gated MIBI scans and volumes measured with RNV, end-diastolic diameter (EDD) versus end-diastolic volume (EDV) r = 0.78 (P= <0.001) at rest and r = 0.74 (T= <0.001) on exercise and end-systolic diameter (ESD) versus end-systolic volume (ESV) r = 0.72 (T= <0.001) at rest and r = 0.72 (T= <0.001) onexercise. This produced a sensitivity for detecting CAD of 79% and a specificity of 73%.

These results show that gated MIBI scanning on exercise provides information comparable to RNV so enhancing the diagnostic usefulness of MIBI.

Key Words: Methoxy-isobutyl-isonitrile • gated scintigraphy • myocardial function on exercise


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