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The field of cardiovascular disease diagnosis and management is moving at a very rapid pace. Different diagnostic tools have been invented, some of them measuring the same thing using different physiologic principles and technology. As such, scientists are continuously looking for new applications for already available diagnostic tools. Thanks to that pursuit led by restless investigators, we can now have more sensitive and specific stress tests with the use of myocardial perfusion imaging. In this number of Medicina Universitaria there are two articles addressing new uses of nuclear cardiology imaging. One study addresses the clinical relevance of ST depression in the electrocardiogram in the recovery phase of an exercise stress test by assessing perfusion abnormalities in subjects undergoing a nuclear stress test to diagnose myocardial ischemia. ST depression during the recovery phase has been considered by some as a sign of myocardial ischemia and for others a mere paraphenomenon without clear clinical significance. In this study by De La Peña-Almaguer et al, the prevalence of abnormalities suggesting ischemic changes or fixed defects suggesting old myocardial infarction was elevated, suggesting that ST depression during recovery may not be considered a benign finding. It is not clear if that high prevalence of nuclear isotope uptake abnormalities was higher, lower or the same than the prevalence found in patients with ST depression during exercise. More importantly, it is not clear if the prevalence of such abnormalities was higher in the study group than in those subjects with a high pretest probability of CAD but had no ECG changes at all. Further investigation is needed to clarify the relative importance of the findings by Dr. De La Peña.

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2009-12-09   |   905 visitas   |   Evalua este artículo 0 valoraciones

Vol. 11 Núm.42. Enero-Marzo 2009 Pags. 3 Med Univer 2009; 11(42)