Ortega-Ramírez JA, Valenzuela-Flores AG, Gaxiola-Alcántar A, Estrada-Alcántara H, Pérez-Campos JP

Idioma: Español
Referencias bibliográficas: 50
Paginas: 471-478
Archivo PDF: 73.98 Kb.

RESUMEN

Objetivo: evaluar la precisión de la perfusión miocárdica y la función ventricular mediante centelleografía cardíaca (sestamibi-Tc⁹⁹ SPECT) sincronizada al electrocardiograma, para diferenciar el daño ventricular de origen isquémico del derivado de la miocardiopatía dilatada. Material y métodos: fueron incluidos pacientes con daño miocárdico con fracción de expulsión de 30%. A todos se les realizó centelleografía cardíaca sincronizada con el electrocardiograma, para evaluar la sensibilidad y especificidad del diagnóstico por gammagrafía en comparación con el cateterismo cardíaco. Resultados: se estudiaron 30 enfermos con daño miocárdico, 26 hombres (86.7%) y cuatro mujeres (13.3%), con edad media de 45.7 ± 9.3 años. El diagnóstico establecido por cateterismo cardíaco fue de miocardiopatía dilatada en 17 enfermos (56.6%) y 13 con miocardiopatía isquémica (43.4%). El estudio por gammagrafía cardíaca sincronizada con el electrocardiograma estableció el diagnóstico de miocardiopatía dilatada en 18 enfermos, con sensibilidad de 100% y especificidad de 92%. El valor predictivo positivo fue de 100% y el valor predictivo negativo de 94.4%. Conclusiones: en forma no invasiva y con una sensibilidad y especificidad altas, la gammagrafía cardíaca sincronizada con el electrocardiograma diferencia el daño miocárdico producido por miocardiopatía dilatada del de origen isquémico.

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