Lynne L. Johnson

Accuracy of dipyridamole SPECT imaging in identifying individual coronary stenoses and multivessel disease in women versus men

The concordance between perfusion image results and cardiac catheterization for individual coronary territories for women was 75%, and for men, it was 65% (P=.09). In women, the presence of disease of the left anterior descending coronary artery was detected more frequently than it was in men, 84% versus 44% (P=.004). The detection of disease in the territories of the left circumflex and right coronary arteries was similar for both groups. For women, the accuracy of perfusion imaging in identifying the presence/absence of multivessel coronary disease was 64%, compared with 71% for men (P=not significant).BackgroundOlder women frequently undergo dipyridamole perfusion imaging and can have advanced coronary artery disease, but little data exist on the accuracy of perfusion imaging in detecting disease in individual vascular territories and multivessel disease in women, compared with men.Methods and ResultsFrom a database of patients undergoing myocardial single photon emission computed tomography (SPECT) perfusion imaging, 107 unselected sequential patients (58 women, 49 men) who underwent sestamibi dipyridamole stress and cardiac catheterization within 6 months of each other were identified. Data were analyzed to compare sensitivities for detection of individual coronary stenoses and multivessel disease.ConclusionsThe accuracy of dipyridamole sestamibi SPECT imaging in detecting multivessel disease was similar for men and women. The sensitivity of dipyridamole sestamibi SPECT imaging in detecting disease of the left anterior descending artery was better in women.

Assessment of coronary artery disease in women.

Stress radionuclide myocardial perfusion imaging and stress echocardiography are noninvasive imaging techniques with high diagnostic and prognostic utility. Previously, patient cohorts for studies using these methods have comprised predominantly men, but recent investigations have focused on women. Stress myocardial perfusion imaging is highly accurate for diagnosing coronary disease in women, particularly with newer techniques such as gated single-photon emission computed tomography, and has been shown to be a powerful prognostic predictor in both women and men. Comparable data for stress echocardiography are emerging. Older studies reported that for similar image findings fewer women than men were referred for invasive procedures, however, newer studies suggest an absence of such a gender bias. Further developments in attenuation correction for perfusion imaging and phase-contrast magnetic resonance imaging promise to enhance the utility of noninvasive imaging for both men and women.