SPECT Dipyridamole scintigraphy for detecting coronary artery disease in patients with isolated severe aortic stenosis

ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers

“…Occasionally, MPI was preferred to angiography due to specific clinical considerations, which has become a more frequent occurrence with the advent of transcatheter aortic valve replacement (TAVR). A number of small studies have evaluated the diagnostic accuracy and to varying degrees the safety and tolerability of dipyridamole (141 patients), [42][43][44] adenosine (180 patients), [45][46][47][48] and regadenoson (50 patients). 49 When assessed, there were no significant differences in the hemodynamic responses between patients with severe aortic stenosis and controls.…”

Valor preditivo da angina em detectar doença coronariana em pacientes com estenose aórtica grave a partir da quinta década de vida

“…We did not use noninvasive methods with physical or pharmacological stress which could help to discriminate patients with and without CAD, as was very elegantly described by Avakian et al 16 In that study, the researchers compared the value of single photon emission computed tomography (SPECT) with thallium during pharmacological stress with dipyridamole with that of coronary angiography in 110 patients with AS. They observed that SPECT was useful in excluding CAD in patients with typical angina, as well as in those asymptomatic or without typical angina.…”

New Imaging Techniques in the Assessment of Patients with Aortic Stenosis

“…Some studies using vasodilator agents such as adenosine or dipyridamole have found high sensitivity (85-100%) for diagnosing significant coronary artery disease [49], although lower sensitivity (57-77%) in comparison with stress echocardiography [50]. Myocardial scintigraphy has higher sensitivity and positive predictive value in patients in whom symptoms of typical angina are present [51], and higher sensitivity and specificity in men than in women [52]. However, cardiac catheterization is still the unique technique for reliably ruling out the existence of concomitant coronary artery disease in patients with aortic stenosis, and the applications of nuclear medicine in these patients are still out of the clinical practice: the assessment of coronary flow reserve and the evaluation of myocardial metabolism.…”