Diagnostyka choroby niedokrwiennej serca za pomocą scyntygrafii perfuzyjnej z użyciem izotopu 99mTc-MIBI u pacjentów chorujących lub diagnozowanych w kierunku stabilnej choroby wieńcowej

Introduction. Myocardial perfusion single-photon emission computed tomography (SPECT) is a diagnostic method using radionuclides to assess heart muscle perfusion. The aim of this study was to assess adherence to the European Society of Cardiology (ESC) guidelines in referring patients to SPECT and to evaluate the occurrence of perfusion disorders depending on the type of indication. Material and methods. The study included 100 outpatients (45 males), of mean age 65 ± 10 years, who were referred for SPECT in the John Paul II Hospital in Krakow. According to the 2013 ESC Guidelines of stable coronary artery disease (CAD) management, indications for this study are those patients: with electrocardiogram (ECG) anomalies at rest, which prevent its accurate interpretation during stress (1st); with pacemaker (2nd); who are symptomatic with prior revascularisation (3rd); who are unable to exercise adequately during a stress test (4th); and with uncharacteristic chest pain (5th). Patients were divided into two groups according to their SPECT study result. Group 1 comprised patients with perfusion disorders, and Group 2 patients without perfusion disorders. Results. SPECT perfusion disorders were detected in 53 patients (53%) (these patients made up Group 1). Compliant with ESC Guidelines referrals included: 8% of patients with the 1st indication, 2% with the 2nd, 24% with the 3rd, 15% with the 4th and 23% with the 5th. Apart from the aforementioned indications, referrals including ‘CAD’ and ‘another heart arrhythmia’ were noted in 32% and 7%, respectively. From all the above mentioned ESC indications for SPECT, we observed statistically significant differences in the prevalence of perfusion disorders solely in patients with the 3rd indication on their referrals (p = 0.013). Conclusions. Overall, 72% of referrals in this study were compliant with ESC Guidelines. The most common indications for SPECT were ‘CAD’ and ‘symptomatic patients with prior revascularisation’. Only the group of patients with the 3rd indication had statistically significantly more frequent perfusion disorders in SPECT.