Manfroi et al Identification of ischemia by angiography vs scintigraphy

Objective – To evaluate and compare the usefulness of cineventriculographies, before and after nitrate use, to technetium-99m sestamibi scintigraphy for the identifi-cation of myocardial ischemia. Methods – Twenty-six patients were studied at basal conditions and 5 minutes after intravenous administration of isosorbide mononitrate (0.3mg/kg), to evaluate the per-formance and regional wall motion of the left ventricle (LV). The results were compared to those obtained with te-chnetium-99m sestamibi scintigraphy. Results – Before nitrate, contrast ventriculography identified 30 normal segments, 62 hypokinetic segments, 28 dyskinetic segments, and 14 akinetic segments. After drug administration, 99 segments were normal, 11 hy-pokinetic, 11 dyskinetic, and 13 akinetic. Myocardial scintigraphy revealed 110 ischemic segments and 18 fibrotic segments (p<0.005). After drug administration, the ventriculography showed increase in the velocity of circumferential fiber shortening (p=0.0142), the ejection fraction (p=0.0462), decrease in the end-systolic volume (p=0.0031) and no change in end-diastolic volume. Conclusion – Contrast ventriculography using nitrate proved to be similar to perfusional myocardial scintigraphy in the identification of myocardial ischemia