SBP ratio in exercise stress testing: validation by perfusion imaging

• Published in: Journal of cardiovascular medicine (Hagerstown, Md.) Vol. 14; no. 10; p. 714
• Main Authors: Bartolini, Matteo, Massi, Lucia, Settimo, Leonardo, Mema, Artur, Pupi, Alberto, Sciagrà, Roberto
• Format: Journal Article
• Language: English
• Published: United States 01.10.2013
• Subjects: Aged; Blood Pressure; Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography; Coronary Artery Disease - diagnosis; Coronary Artery Disease - physiopathology; Exercise Test; Female; Humans; Male; Middle Aged; Myocardial Perfusion Imaging - methods; Predictive Value of Tests; Retrospective Studies; Stroke Volume; Systole; Time Factors; Ventricular Function, Left
• ISSN: 1558-2035
• DOI: 10.2459/JCM.0b013e32835dbd44

The 3-min SBP ratio (SBPR) was proposed to detect significant coronary artery disease (CAD), but its relationship with abnormalities detected by myocardial perfusion-gated single-photon emission computed tomography (SPECT) was never examined. In 156 consecutive patients submitted to resting and exercise gated SPECT for suspect CAD, perfusion scores, ejection fraction and transient ischemic dilatation (TID) were evaluated and compared with SBPR. There were weak correlations between SBPR and summed stress score (ρ = 0.232, P < 0.004), and summed difference score (SDS) (ρ = 0.228, P < 0.004). According to receiver operating characteristic analysis, SBPR was poorly effective for identifying patients with inducible ischemia (SDS ≥ 2): area under curve = 0.64, (P < 0.002), sensitivity = 82%, specificity = 40%. No relationship was registered between SBPR and postexercise ejection fraction drop, and the relationship with TID was poor (ρ = 0.263, P < 0.001). In patients submitted to gated SPECT for suspect CAD, SBPR appears poorly effective for the detection of significant CAD, and does not show any valuable relationship with exercise-induced functional abnormalities.