Bruno Gomes Padilha et al. Daniela Sabino Maria Clementina Giorgi José Soares Jr. … Marisa Izaki José Claudio Meneghetti
Introduction
Coronary angiography (CAG) is the standard diagnostic method for detection of coronary artery disease (CAD). However, it is often necessary to evaluate the expression of a coronary obstruction in relation to myocardial perfusion, before defining the best patient management.
Myocardial perfusion scintigraphy with technetium-99m-Sestamibi (99mTc-sestamibi) allows early detection and evaluation of disease extension and cardiovascular risk in patients with suspected or established CAD, helping in decision-making regarding the start and type of therapy to be implemented. This method has been widely used, but shows difficulties in some situations such as balanced multivessel disease, in which the proportional flow distribution in the myocardial regions can hinder ischemia detection. In such cases, additional assessment data, such as evaluation of contractility, decrease in left ventricular ejection fraction (LVEF) under stress, electrocardiographic alterations or symptoms during stress, dilation of the left ventricle (LV) cavity under stress can provide evidence of ischemia, indicating further diagnostic investigation.
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