The application of radionuclide ventriculography to cardiac screening

Abstract

Summary:Screening asymptomatic individuals for latent coronary disease often requires sequential testing because exercise electrocardiography typically produces more false positive than true positive results in a population with a low prevalence of coronary disease. Cardiac scintigraphy is a technique that may be employed as a confirmatory test in lieu of coronary arteriography to further evaluate the significance of a positive exercise electrocardiogram.Radionuclide ventriculography was employed in 98 asymptomatic individuals who were considered to be at moderate risk of heart disease after risk factor analysis and exercise electrocardiography. Seventeen (17 %) patients had an abnormal study and underwent cardiac catheterization. Seven had coronary artery disease, two had cardiomyopathy , and eight were normal. Eighty-one (83%) patients had a normal study. Because the sensitivity of radionuclide ventriculography is 63-80%, it was postulated that 2 to 5 individuals with disease were missed. Thus, from a population with an 1*1-14% prevalence of disease, two subsets were identified. A large subset in which a prevalence of 2-6% could be estimated was separated from a much smaller one in which a prevalence of approximately 50 % was demonstrated.