Gender Differences, Defect Reversibility, And Imaging Position: Importance For Diagnosis Of Coronary Artery Disease Using A Cadmium-Zinc-Telluride Nuclear Cardiology Camera
Posted Date: Dec 24, 2019
- Investigator: Myron Gerson
- Specialties: Cardiology, Heart Disease
- Type of Study: Device
ABSTRACT Background: Limited data address the roles of gender, perfusion defect reversibility, and imaging position in interpretation of images acquired on an upright/supine cadmium-zinc-telluride (CZT) cardiac imaging system. Methods and Results: From a consecutive cohort of patients imaged on an upright/supine CZT camera, 260 patients with coronary angiograms were studied. Multivariable models identified gender as a significant co-variate for imaging variables predictive of CAD. For males, a supine summed stress score (SSS)=3provided high accuracy (sensitivity 70.7%, specificity 72.2%), and highest contribution to multivariable models. In females, supine SSS=2 provided the best cut-off for defect size and severity (sensitivity 90%, specificity 35.9%), but specificity was improved substantially to 53.3% with decrease in sensitivity to 80% by also requiring quantitative identification of perfusion defect reversibility in the supine position. Eight variables, accurate for predicting coronary disease, were more accurate with supine than upright imaging. Conclusions: Perfusion defect reversibility improved specificity in female patients for detection of coronary disease compared to perfusion defect size and extent alone. Supine images provided superior accuracy for detection of coronary disease compared to upright images.
For More Information: