Use of resting myocardial scintigraphy during chest pain to exclude diagnosis of acute myocardial infarction.

نویسندگان

  • Gustavo Borges Barbirato
  • Jader Cunha de Azevedo
  • Renata Christian Martins Felix
  • Patricia Lavatori Correa
  • André Volschan
  • Monica Viegas
  • Lucia Pimenta
  • Hans Fernando Rocha Dohmann
  • Evandro Tinoco Mesquita
  • Claudio Tinoco Mesquita
چکیده

BACKGROUND Images of myocardial perfusion taken during an episode of chest pain have been used for patients in the emergency department. OBJECTIVE To evaluate the operating characteristics of 99mTc-Tetrofosmin scintigraphy during an episode of chest pain to exclude the diagnosis of acute myocardial infarction. METHODS One hundred and eight patients admitted with chest pain, or up to four hours after the end of symptoms and nondiagnostic electrocardiogram, underwent resting scintigraphy and measurement of troponin I concentrations. Patients with a history of myocardial infarction (MI) were not excluded (24 patients). Troponin I concentrations were determined at admission and 6 hours later. Nuclear physicians performed a blind analysis of the images, and myocardial infarction was confirmed whenever troponin I level increase was three times that of the control. RESULTS Resting perfusion image was abnormal in all 6 patients with MI. Only 1 patient had a normal image and increased troponin levels. Fifty-five patients had positive images without MI, and 46 patients had normal images and troponin levels. The prevalence of the disease was 6.5%. The sensitivity and specificity of the resting images during an episode of chest pain to diagnose MI was 85.7% and 45.5%, respectively. The negative predictive value was 97.7%. CONCLUSION Patients undergoing chest pain protocol with SPECT showed an excellent negative predictive value to exclude diagnosis of myocardial infarction. These results suggest that resting perfusion image is an important tool at the chest pain unit.

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عنوان ژورنال:
  • Arquivos brasileiros de cardiologia

دوره 92 4  شماره 

صفحات  -

تاریخ انتشار 2009