Zeki DOSTBİL, Habib ÇİL, Zuhal Arıtürk ATILGAN, Ebru TEKBAŞ, BUĞRA KAYA, Savaş SARIKAYA

Miyokard perfüzyon sintigrafsi, eforlu EKG ve koroner anjiograf sonuçlarının karşılaştırılması

Amaç: Koroner arter hastalığı tüm dünyada en sık görülen mortalite ve morbidite sebeplerinden birisidir. Koroner arterlerdeki aterosklerotik darlığın kesin tanısında koroner anjiograf kullanılmaktadır. Bu çalışmada koroner arter hastalığı tanısında kullanılan eforlu EKG ve miyokard perfüzyon sintigraf ve koroner anjiograf bulguları karşılaşrtırıldı. Gereç ve Yöntem: 101 hasta (47 erkek, 54 kadın; yaş ortalaması: 55 ± 10.95 yıl) çalışmaya alındı. Bu hastalara treadmill cihazıyla efor yaptırılarak 99m Tc-MIBI miyokard perfüzyon sintigrafsi çekildi. Bir ay içerisinde koroner anjiograf yapılan hastalar çalışmaya dahil edildi. Bulgular: Efor testi pozitif olan hastaların %55’i, şüpheli olanların %82’si ve negatif olanların ise %29’unda koroner anjiografde darlık tespit edilirken miyokard perfüzyon sintigrafsinde iskemi gözlenen hastaların %66’sında ve normal değerlendirilen hastaların %12’sinde darlık görüldü. Sonuç: Koroner arter darlığının tanı ve takibinde efor testi ve miyokard perfüzyon sintigrafsi gibi noninvaziv testler kullanılmaktadır. Bu testlerin sonuçları birlikte değerlendirildiğinde koroner arter darlığını göstermedeki doğrulukları artmaktadır.

Comparison of results of myocardial perfusion scintigraphy, effort stress testing and coronary angiography

Aim: Coronary artery disease is one of the most frequent causes of mortality and morbidity seen all over the world. In defnite diagnosis of the atherosclerotic coronary artery stenosis, coronary angiography is used. In this study, additional contribution of the effort stress testing together with myocardial perfusion scintigraphy, which are noninvasive tests, to choose patients to coronary angiography. Materials and Methods: 101 patients (47 men, 54 women; mean age: 55 ± 10.95 year) were included into the study. In all patients 99m Tc-MIBI myocardial perfusion scintigraphy was performed following physiological effort on treadmill. Patients in whom coronary angiography were performed in 1 month before or after scintigraphic evaluation were included into the study. Results: In 55% of patients having positive effort stress testing, 82% of patients having suspicious and 29% of patients with negative test results atherosclerotic narrowing in coronary arteries were detected by angiography. Whereas, in 66% of patients had ischemic myocardial perfusion scintigraphic fndings and 12% of patients with normal scintigraphy, angiography revealed coronary artery stenosis. Conclusion: In diagnosis and follow-up of coronary artery disease, effort stress testing and myocardial perfusion test are used. If fndings of these tests are evaluated together, accuracy of the tests will be increased.

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