Stress SPECT Myocardial Perfusion Imaging (SPECT-MPI) can be considered as a useful and sensitive non-invasive method to detect the severity of coronary artery lesion. The procedure is better known as cardiac scan. SPECT-MPI is most popular in the United States among other diagnostic methods available like treadmill exercise test, stress echocardiography, left heart catheterization with left ventriculogram and coronary angiography etc.
- High clinical suspicion with negative exercise test.
- Low clinical suspicion with positive exercise test.
- Borderline or uninterpretable exercise test.
- Resting ECG precludes stress ECG test
- Culprit vessel identification in multi-vessel disease.
- Assessment of post Coronary Artery Bypass Graft (CABG) or PTCA.
- Identifying hibernating myocardium (aids decision making when considering revascularisation)
- Work up for cardiac transplantation (to help exclude coronary revascularisation as an option)
- Risk stratification prior to major non-cardiac surgery (e.g. vascular surgery)
Benefit of the procedure
It is a non-invasive procedure to find out the problem caused by coronary artery diseases and others. Moreover, as all people do not need coronary angiogram. It is cheaper than the coronary angiogram.
The facility is available in the country
Many people seeking medical treatment for cardiac care in abroad undergo through cardiac scan. They feel comfortable with the procedure, as it is non-invasive and almost equally effective like coronary angiogram. Some of them go repeatedly to perform the test and most of them do not know that it is done in the country.
SPECT-MPI is done in Bangabandhu Sheikh Mujib Medical University (BSMMU) with the help of Institute of Nuclear Medicine.
A prospective study at BSMMU
In this connection, a prospective study observational study was carried out in the department of Cardiology and Institute of Nuclear Medicine of Bangabandhu Sheikh Mujib Medical University (BSMMU) during two years.
The purpose of the study was to find out the correlation between severity of coronary artery stenosis (condition where a passage becomes narrow) and myocardial perfusion defect as assessed by SPECT.
Significant correlation was observed between perfusion defect and coronary artery lesions. Severe perfusion defect in SPECT scan found positive correlation with severe coronary artery lesion with higher correlation coefficient. Mild perfusion defect in SPECT scan found positive correlation with moderate coronary artery lesion with higher correlation coefficient. Regarding moderate perfusion defect by SPECT scan found positive correlation with severe coronary artery lesion with lower correlation coefficient.
The study found SPECT-MPI as a useful and sensitive non-invasive method of detecting severity of coronary artery lesion.
Dr S M Mustafa Zaman, Assistant Professor of Department of Cardiology of BSMMU carried out the scientific study in his department during two years. The research paper was submitted for "Singapore Live 2006" conference and was accepted to present there. It was the only research work to present in the conference from Bangladesh.
