Non-invasive diagnosis of coronary artery disease by 123I-BMIPP/201TlCl dual myocardial SPECT in patients with heart failure

Abstract Background/objectives Detecting the presence of coronary artery disease (CAD) is critically important in managing patients with heart failure of uncertain cause. The recently introduced 123 I-BMIPP/ 201 TlCl dual myocardial single-photon emission computed tomography (dual SPECT) is potentially a non-invasive diagnostic tool in detecting ischemic heart disease. The aim of our study is to evaluate the efficacy of detecting CAD by dual SPECT in patients with heart failure. Methods We studied 501 consecutive patients (366 males, mean age 68±12years) who were admitted because of heart failure between January 2005 and April 2009. In all patients, the dual SPECT was performed in clinically stabilized states, followed by coronary angiography within 1week. The polar map of the SPECT image was divided into 17 segments, each scored on a scale of 0–4 based on segmental percent uptake. The mismatch score was defined as the difference between 123 I-BMIPP defect score and 201 TlCI defect score. The uptake of 201 TlCl and 123 I-BMIPP was analyzed quantitatively using the Heart Score View software. Results The 201 TlCI defect score and mismatch score were significantly higher in CAD patients than in non-CAD patients. The receiver operating characteristic (ROC) curve revealed that the mismatch score was a significantly more effective marker in detecting the presence of CAD than 201 TlCl defect score (area under the curve: 0.84 versus 0.73, p Conclusion Dual SPECT is a useful non-invasive procedure for the detection of CAD in patients with heart failure.