Comparison of Exercise Stress Testing with Simultaneous Dipyridamole Stress Echocardiography and Technetium-99m Isonitrile Single-Photon Emission Computerized Tomography for Non-Invasive Diagnosis of Coronary Artery Disease

To compare the value of exercise stress testing w ith simultaneous dipyridamole stress echocardiography and technetium-99m isonitrile single photon emission computed tomography for the diagnosis of coronary artery disease, twenty-six patients with suspected coronary artery disease underwent simultaneous dipyridamole stress echocardiography and dipyridamole technetium-99m isonitrile single photon emissian computed tomography and tr adınili exercise test, after stopping the antianginal treatment. All patients underwent coronary angiography as a gold standard reference. Dipyridamole mibi SPECT showed higher overall sensitivity than exerc ise testing (93 vs 69%, p<0.05) and similar sensitivity to dipyridamole echocardiography (93 vs 8 1 %, p>0.05). This was mainly due to higher se tiv iı y of dipyridamole mibi SPECT than exercise testing in twovessel disease (100 vs 57%, p<0.05). Dipyridamole mibi SPECT showed even higher sensitivity than dipyridamole echocardiography in two-vessel disease (100 vs 71 %, p<0.05). All three tesıs sh o wed similar sensitivities in one (75, 75 vs 50%, p>0.05) and three-vessel disease (ı 00, ı 00 vs ı 00%, p<0.05). Also, all of them showed similar diagnostic accuracy (88, 85 and 70, p>0.05). The results of dipyridamole mibi SPECT and dipyridamole echocardiography were concordant in 20 patients (78%, Kappa=0.58). In this study, dipyridamole mibi SPECT showcd the highest sensitivity; where the difference between the sensitivities of dipyridamole mi bi SPECT and exereise test was statistically significant, but betwccn mibi SPECT and dipyridamole echocardiography was not significant. All three te s showed simil ar specificities. It also disclosed that the combination of dipyridamole with mibi SPECT is an effcctivc, valuable and safe method, which in combination with echocardiography reaches a similar diagnostic accuracy as mibi SPECT combination.