[Gated single photon emission computer tomography for the detection of silent myocardial ischemia].

BACKGROUND Asymptomatic patients with severe coronary atherosclerosis may have a normal resting electrocardiogram and stress test. AIM To assess the yield of Gated Single Photon Emission Computer Tomography (SPECT) for the screening of silent myocardial ischemia in type 2 diabetic patients. MATERIAL AND METHODS Electrocardiogram, stress test and gated-SPECT were performed on 102 type 2 diabetic patients aged 60+/-8 years without cardiovascular symptoms. AH subjects were also subjected to a coronary angiography whose results were used as gold standard. RESULTS Gated-SPECT showed myocardial ischemia on 26.5% of studied patients. The sensibility, specificity accuracy, positive predictive value and negative predictive value were 92.3%, 96%, 95%, 88.8%, 97.3%, respectively. In four and six patients ischemia was detected on resting electrocardiogram and stress test, respectively. Eighty percent of patients with doubtful resting electrocardiogram results and 70% with a doubtful stress test had a silent myocardial ischemia detected by gated-SPECT There was a good agreement between the results of gated-SPECT and coronary angiography (k=0.873). CONCLUSIONS Gated-SPECT was an useful tool for the screening of silent myocardial ischemia.