RESUMO
To study whether combination of pharmacological stress test using Adenosine infusion with dynamic exercise of 25 watts, enhances the detection of Coronary Artery Disease. [CAD] Design: Prospective study involving 660 consecutive patients referred for myocardial perfusion SPECT. Setting: Punjab Institute of Cardiology, Lahore. Subjects: Of the referred 660 patients the first 160 patients under-went a pharmacological stress test using Adenosine only [Group A]. In the next 500 patients [Group B] adenosine infusion was combined with dynamic exercise of 25 watts for six minutes. Coronary Angiography results were available in 90 patients, 40 in Group A and 50 in Group B. Segmental analysis of thallium-201 SPECT revealed an overall sensitivity and specificity was similar in both groups [87% vs 90% and 84% vs 88% respectively]. For RCA lesions the sensitivity was 82% for Group A and 90% for Group B. Conclusions: Use of dynamic exercise in addition to Adenosine decreases the drug related side effects and it appears to be more sensitive in detection of RCA lesions