Tc-99m sestaMIBI SPECT imaging in angina patients with echocardiographic left ventricular hypertrophy (LVH)

Left ventricular hypertrophy (LVH) is relatively common, occurring in 15-20% of the general population. LVH were known to exert an adverse influence on the accuracy of myocardial perfusion scintigraphy. However, most studies were done in the patients having hypertension. The diagnostic accuracy of the stress myocardial perfusion scan in the normotensive patients with LVH for the detection of significant coronary artery disease has not been separately examined. This study was prepared to determine the diagnostic accuracy of Tc-99m myocardial perfusion scan in patients with echocardiographic LVH. Tc-99m sestaMIBI myocardial scan was performed with either exercise (n=40) or adenosine (n=44) stress in 84 consecutive anginal patients with normal ECG. Fifty nine patients had significant coronary artery disease (>50%) in coronary angiogram. Overall sensitivity and specificity of the SPECT imaging were 88%, and 84% respectively. The patients were divided into two groups ; 1) LVH= patients with echocardiographic LVH(n=29) and 2) No LVH =patients without echocardiographic LVH(n=55). Sensitivities were 88% in both groups. Specificities were 67% in LVH and 100% in No LVH group ( p < 0.05). Fifty seven patients were normotensive and analyzed separately (LVH group =20, No LVH group = 37). Exercise stress was done in 29 and adenosine in 28 patients. Sensitivities and specificities were not significantly different in LVH and No LVH groups (83% vs 86%, p=NS and 88% vs 100%, p= NS) for the detection of coronary artery disease. Echocardiographic LVH does not appear to affect the diagnostic value of the Tc-99m sestaMIBI SPECT imaging in the normotensive angima patients