Vallejo E, Acevedo C, Varela S, Alburez JC, Bialostozky D

Idioma: Español
Referencias bibliográficas: 29
Paginas: 6-13
Archivo PDF: 94.71 Kb.

RESUMEN

La evaluación de la perfusión miocárdica con single photon emission computed tomography (SPECT) está indicada en pacientes con sospecha de cardiopatía isquémica (CI). Sin embargo, el costo del estudio, el tiempo de adquisición y la radiación limitan su indicación. Objetivos: Demostrar que el protocolo sólo-estrés del SPECT cardíaco es suficiente para establecer el diagnóstico en pacientes con sospecha de CI, optimizando los recursos en cardiología nuclear. Métodos: 122 pacientes con sospecha de CI fueron evaluados con el protocolo sólo-estrés. Para evaluar los valores diagnóstico y pronóstico de este protocolo, los pacientes con SPECT anormal fueron evaluados con angiografía invasiva y los pacientes con SPECT normal fueron evaluados clínicamente durante tres años. Resultados: Con el protocolo sólo-estrés se obtuvo el diagnóstico en el 30% del tiempo requerido por el protocolo convencional, con un costo un 40% menor y con un 55% menos de radiación. La certeza diagnóstica y el valor pronóstico del protocolo sólo-estrés fueron comparables con los del protocolo convencional: valor predictivo positivo para enfermedad arterial coronaria (EAC) del 85% y valor predictivo negativo para eventos coronarios del 97%. Conclusiones: En pacientes con riesgo intermedio para CI, evaluar la perfusión miocárdica sólo con la fase de estrés es una estrategia que optimiza los recursos en cardiología nuclear y conserva el valor diagnóstico y pronóstico de la prueba.

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