Utilidad de la tomografía computarizada de emisión de fotón único sincronizada con el electrocardiograma para la detección de isquemia miocárdica silente en diabéticos tipo 2

• Yamilé Peña Q ^[1] ; Marco Antonio Coca P ^[1] ; Juan Felipe Batista C ^[1] ; José Fernández-Britto R ^[2] ; Rodobaldo Quesada P ^[1] ; Andria Peña C ^[1]
  1. [1] Centro de Investigaciones Clínicas
  2. [2] Centro de Investigación y Referencia de Aterosclerosis
• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 137, Nº. 8, 2009, págs. 1023-1030
• Idioma: español
• Títulos paralelos:
  • Gated single photon emission computer tomography for the detection of silent myocardial ischemia
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• Resumen

  • 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, specifity 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.