OBJECTIVE: To compare Dual-Head coincidence gamma camera (DCD-AC) with dobutamine stress echocardiography (DSE) in viability assessment, using functional recovery as the gold standard. METHODS: Twenty-one patients were prospectively studied, with coronary artery disease and severe left ventricular dysfunction undergoing DSE and DCD-AC at baseline and DSE three months after revascularization. RESULTS: Of the 290 segments analyzed, 83% were akinetic, 15% hypokinetic and 2% dyskinetic at rest. DSE identified 68% of these segments as non-viable. DCD-AC identified 56% of these segments as normal (dysfunctional segments with preserved metabolism and perfusion), 30% as viable (preserved metabolism and reduced perfusion) and 14% as non-viable (reduced perfusion and metabolism). Of the DSE non-viable segments, DCD-AC identified 80% as normal or viable and 19.9% as non-viable (p<0.001). In hypokinetic segments viability and normal segments were detected in a higher proportion by both methods (p<0.001). DSE sensibility and specificity were 48.3% and 78.1% respectively. DCD-AC sensibility and specificity was 92.2% and 20.0%. DCD-AC identifies a higher incidence of function improvement in normal segments than in viable and non-viable. CONCLUSION: DCD-AC classified as normal or viable most of the non-viable DSE segments. In assessment of functional recovery segments after three months, DCD-AC showed a high sensibility but low specificity.
dobutamine echocardiography; dual-head gamma camera; myocardial viability; fluorodeoxyglucose; coronary artery bypass surgery
