TY - JOUR
T1 - Improvement of diagnosis in the non-invasive assessment of coronary artery disease
T2 - Enhanced evaluation of quantitative exercise 201thallium imaging by multivariate analysis
AU - Niemeyer, Menco G.
AU - Zwinderman, Aelko H.
AU - Cramer, Maarten J.
AU - Van Der Wall, Ernst E.
AU - Verzijlbergen, Fred J.
AU - Breeman, Arno
AU - Ascoop, Carl A.
AU - Pauwels, Ernest K.J.
PY - 1990/1/1
Y1 - 1990/1/1
N2 - Study objective - The aim was to evaluate discriminant analysis, performed in patients without prior myocardial infarction, in enhancing the diagnostic value of quantitative exercise 201thallium scintigraphy.Design - All clinical, electrocardiographic, and scintigraphic variables were first subjected to a univariate analysis. Afterwards a discriminant analysis was done.Patients - 135 patients (104 male) were studied. Age was 24-70 years, mean 55 years.Measurements and main results - Two discriminant analyses were done. In the first analysis, the ability to detect the presence of coronary artery disease was tested. Significant variables were: (1) history of angina, (2) sex, (3) quantitative analysis of 201thallium scintigraphy, (4) age, (5) ischaemic ST response, (6) angina during the test, and (7) the pressure-rate product. The sensitivity, specificity, and accuracy of classification using the discriminant function were 91%, 87%, and 90%, respectively. The sensitivity was higher than when using only visual interpretation (sensitivity 70%; p<0.0002) or quantitative interpretation (sensitivity = 66%; p<0.000l) of thallium scans, without significant loss of specificity (p<0.5488; p<0.6875). In the second analysis, a discriminant function was calculated to detect multivessel disease. Five input variables were selected: (1) number of vessels with stenosis predicted by quantitative analysis, (2) number of vessels with stenosis predicted by visual analysis, (3) ischaemic ST response, (4) sex, (5) angina during the test. Multivariate analysis showed an increase in sensitivity when compared with visual interpretation (78% v 55%; p<0.0043) and quantitative analysis (66%; p<0.0156). Using the classification, the discriminant function was more accurate than visual analysis (81% v 69%) or quantitative analysis (77%).Conclusions - The results show that multivariate analysis of non-invasive test results in quantitative thallium exercise testing allows convenient use for clinical purposes with improved results.
AB - Study objective - The aim was to evaluate discriminant analysis, performed in patients without prior myocardial infarction, in enhancing the diagnostic value of quantitative exercise 201thallium scintigraphy.Design - All clinical, electrocardiographic, and scintigraphic variables were first subjected to a univariate analysis. Afterwards a discriminant analysis was done.Patients - 135 patients (104 male) were studied. Age was 24-70 years, mean 55 years.Measurements and main results - Two discriminant analyses were done. In the first analysis, the ability to detect the presence of coronary artery disease was tested. Significant variables were: (1) history of angina, (2) sex, (3) quantitative analysis of 201thallium scintigraphy, (4) age, (5) ischaemic ST response, (6) angina during the test, and (7) the pressure-rate product. The sensitivity, specificity, and accuracy of classification using the discriminant function were 91%, 87%, and 90%, respectively. The sensitivity was higher than when using only visual interpretation (sensitivity 70%; p<0.0002) or quantitative interpretation (sensitivity = 66%; p<0.000l) of thallium scans, without significant loss of specificity (p<0.5488; p<0.6875). In the second analysis, a discriminant function was calculated to detect multivessel disease. Five input variables were selected: (1) number of vessels with stenosis predicted by quantitative analysis, (2) number of vessels with stenosis predicted by visual analysis, (3) ischaemic ST response, (4) sex, (5) angina during the test. Multivariate analysis showed an increase in sensitivity when compared with visual interpretation (78% v 55%; p<0.0043) and quantitative analysis (66%; p<0.0156). Using the classification, the discriminant function was more accurate than visual analysis (81% v 69%) or quantitative analysis (77%).Conclusions - The results show that multivariate analysis of non-invasive test results in quantitative thallium exercise testing allows convenient use for clinical purposes with improved results.
KW - 201thallium scintigraphy
KW - Coronary artery disease
KW - Exercise
KW - Multivariate analysis
UR - http://www.scopus.com/inward/record.url?scp=85047677456&partnerID=8YFLogxK
U2 - 10.1093/cvr/24.10.804
DO - 10.1093/cvr/24.10.804
M3 - Review article
C2 - 2085835
AN - SCOPUS:85047677456
SN - 0008-6363
VL - 24
SP - 804
EP - 812
JO - Cardiovascular Research
JF - Cardiovascular Research
IS - 10
ER -