Application value between dynamic electrocardiogram and MSCT myocardial perfusion imaging in the diagnosis of myocardial ischemia in coronary heart disease

Abstract

Background: Dynamic electrocardiogram and multi-spiral computed tomography (MSCT) myocardial perfusion imaging are commonly used in clinical examination methods, which can provide important reference for the diagnosis of myocardial ischemia in coronary heart disease. To analyze and compare the application value of dynamic electrocardiogram and MSCT myocardial perfusion imaging in the diagnosis of myocardial ischemia in coronary heart disease. Methods: The clinical data of 79 patients diagnosed with coronary heart disease admitted in our hospital from October 2017 to October 2019 were retrospectively collected. Exercise load/rest myocardial perfusion imaging (MPI) confirmed the presence of myocardial ischemia, and the patients were all examined by dynamic electrocardiogram and MSCT. The diagnosis of exercise load/resting MPI was used as a benchmark to compare the sensitivity, specificity, and accuracy of the different tests in the diagnosis of myocardial ischemia in coronary heart disease.Results: As confirmed by the exercise load/rest MPI, the 79 included patients had myocardial ischemia.Fifty-five cases of myocardial ischemia were detected by dynamic electrocardiogram, of which 33 cases showed horizontal depression of the ST segment. Also, 15 cases exhibited downward oblique depression, and seven cases showed upward oblique depression. MSCT examination showed that 78 patients had myocardial ischemia, of which 74 showed abnormal myocardial perfusion when contracted. Of these patients, 47showed reversible perfusion filling, 20 exhibited partially reversible perfusion filling, and seven showed fixed perfusion defects. The sensitivity, specificity, and accuracy of dynamic electrocardiogram in the diagnosis of myocardial ischemia in coronary heart disease were 60.76%, 72.15%, 69.62%, respectively, while those of MSCT were 91.14%, 75.94%, and 86.07%, respectively. The sensitivity and accuracy of MSCT examination were significantly higher than those of dynamic electrocardiogram examination (P<0.05), and the specificity was slightly higher than that of dynamic electrocardiogram examination, but this difference was not statistically significant (P>0.05). Conclusions: Compared to dynamic electrocardiogram examination, MSCT myocardial perfusion imaging has superior sensitivity and accuracy in the diagnosis of myocardial ischemia in coronary heart disease, and can provide a reference for clinical diagnosis and treatment.

Oxygen pulse variation in symptomatic patients with suspected coronary artery disease: a diagnostic analysis

“…Several studies have evaluated the diagnostic performance of the oxygen pulse using myocardial ischemia detected by myocardial perfusion scan as the diagnostic standard. Belardinelli ( 2 ) showed that ischemia patients diagnosed by Gated- single photon emission computed tomography (SPECT) had a significantly lower peak VO 2 /HR, while Pinkstaff ( 4 ) and Chen ( 5 ) found that the peak VO 2 /HR could not be used to identify patients with myocardial ischemia. This discrepancy could be attributed to the different severities of ischemia in these studies, as oxygen pulse response during incremental exercise might only present with extensive myocardial ischemia ( 17 , 18 ).…”

“…In theory, the development of myocardial ischemia during exercise may decrease heart stroke volume, and may result in changes in oxygen pulse. Over the past 2 decades, most studies have evaluated the diagnostic performance of oxygen pulse using myocardial ischemia detected by myocardial perfusion scan as the diagnostic standard ( 2 , 4 , 5 ). However, to date, there has been little discussion of the value of oxygen pulse compared to coronary artery anatomy data, and different studies have reported different results.…”