Assessment of Heart Rate Recovery with GATED-Myocardial Perfusion Scintigraphy Outcome in Patients with Coronary Artery Disease: A Retrospective Study and Institutional Experience.

Yusuf Ziya Tan,Semra Özdemir,Fatmanur Çelik,Burak Altun

doi:10.4274/mirt.60252

Abstract

Objective: This study aimed to investigate the effects of assessment with myocardial perfusion scintigraphy (MPS) and heart rate recovery (HRrec) measurements in combination to evaluate the current status of patients with a diagnosis or suspicion of coronary artery disease (CAD).Methods: A total of 350 patients were included in the study. CAD group consisted of 200 patients with stable angina pectoris and a known history of CAD, while the control group consisted of 150 patients with suspicious stress test who had no history of known CAD. In order to calculate the HRrec index, the treadmill exercise test was performed in all patients according to the Bruce protocol. The MPS results were evaluated for the presence or absence of myocardial ischemia and infarction by visual and quantitative (summed stress score and summed difference score) assessments.Results:When the MPS results and HRrec were evaluated together, there was no statistically significant difference in the non-CAD group. But, when GATED-MPS was evaluated alone in the triple-vessel patient group, 27 (36%) patients were found to be normal while evaluated with HRrec, four (5.3%) patients were found to be normal.Conclusion:HRrec measurements obtained during stress MPS is important in patient evaluation. Therefore, evaluation of MPS results and HRrec measurements together may provide a more accurate estimation of possible presence of CAD in patients.

Highlights

Coronary artery disease (CAD) is one of the leading causes of mortality in developed countries.effects of assessment with myocardial perfusion scintigraphy (MPS) and Heart rate recovery (HRrec) measurements in combination to evaluate the current status of patients with a diagnosis or suspicion of CAD.Due to the incidence of CAD, there is a need for accurate, inexpensive, and non-invasive imaging methods for both diagnosis and monitoring
Effects of assessment with MPS and HRrec measurements in combination to evaluate the current status of patients with a diagnosis or suspicion of CAD
The study was retrospectively planned on patients who applied to Çanakkale University Faculty of Medicine, Nuclear Medicine Department for MPS with the aim of investigating CAD

Summary

Introduction

Coronary artery disease (CAD) is one of the leading causes of mortality in developed countries.effects of assessment with MPS and HRrec measurements in combination to evaluate the current status of patients with a diagnosis or suspicion of CAD.Due to the incidence of CAD, there is a need for accurate, inexpensive, and non-invasive imaging methods for both diagnosis and monitoring. Effects of assessment with MPS and HRrec measurements in combination to evaluate the current status of patients with a diagnosis or suspicion of CAD. Exercise tests were the initial tests employed in diagnosis of CAD. Changes in heart rate during and immediately after exercise determine the balance between the sympathetic system and vagal activity. During the recovery period after exercise, as the sympathetic activity that increased during exercise reduces, parasympathetic activity increases and causes a reduction in heart rate [1]. Heart rate recovery (HRrec) refers to the decrease in heart rate after exercise. HRrec index is calculated by subtracting the heart rate at the 1st, 2nd and 3rd minutes of the recovery period from the maximum heart rate in a patient performing a submaximal or maximal stress test [2]

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Discussion

Conclusion