The role of myocardial perfusion imaging in the evaluation of patients undergoing percutaneous transluminal coronary angioplasty.

INTRODUCTION We studied the value of myocardial perfusion imaging (MPI) for the evaluation of improvement in myocardial perfusion in patients with successful percutaneous transluminal coronary angioplasty (PTCA). METHODS Sixty patients (10 women, 50 men) aged 54.18 +/- 11.71 years were analyzed. MPI was performed before PTCA, 6-10 days (16 cases), 1-3 months (21 cases), and then 3-6 months (23 cases) after the procedure. In all patients repeated coronary angiography was done at least once after PTCA. Statistical analysis of the numbers of segments with various degrees of perfusion (normal, ischemia, fixed segment), before and after PTCA, was performed for three groups (6-10 days, 1-3 months and 3-6 months after PTCA) separately, using paired T and also ANOVA tests. A p-value <0.05 was considered to be statistically significant. RESULTS Improvement, defined as a decrease in the number of ischemic or fixed segments, was observed in 13 of 16 patients at 6-10 days after PTCA, in 18 of 21 cases 1-3 months after PTCA, and in 20 of 23 patients 3-6 months after PTCA. The sensitivity and specificity of MPI calculated before PTCA and at the 3 subsequent time points, using angiography as the gold standard, were 80/81, 100/35, 90/100, and 76/100 percent, respectively. CONCLUSION Our results confirm the necessity for an assessment of perfusion both before and shortly after angioplasty, since it provides the best documentation of the changes in myocardial perfusion.