Comparison of left ventricular contractility in silent myocardial ischemia by echocardiography and perfusion scintigraphy

Abstract

Aim. The aim of the study was to compare the methods of echocardiography and single-photon emission computed tomography in assessing local left ventricular contractility in silent myocardial ischemia; to consider the possibility of comparing the data of echocardiography and single-photon emission computed tomography of myocardium in such patients. Material and methods. An analysis of the medical literature devoted to the problem of interest was performed. Results and discussion. Echocardiography or single-photon emission computed tomography is commonly used to assess regional left ventricular contractility. Single-photon emission computed tomography provides assessment of both contractile function and myocardial perfusion and viability. Single-photon emission computed tomography is highly reproducible, and more promising for objective assessment of left ventricular function. Singlephoton emission computed tomography can be used to differentiate hypoperfused, but still viable myocardium, from irreversible myocardial fibrosis. The advantages of echocardiography are due to the short duration of the procedure, its low cost and affordability. However, the results of echocardiography are often subjective and depend on the physician’s experience. In addition, Doppler studies are limited by the scanning angle and are not always suitable for patients with a suboptimal ultrasound window. Thus, both echocardiography and single-photon emission computed tomography assess both integral and regional left ventricular contractility. Comparison of echocardiography and single-photon emission computed tomography results helps to understand the comparability of their findings. The results of echocardiography agree with the quantitative assessment of single-photon emission computed tomography. The revealed differences in regional contractility estimations are related both to the methodology of echocardiography and to the specific features of cardiac diseases. Conclusion. Studies used to assess regional left ventricular contractility, such as echocardiography and single-photon emission computed tomography, despite their positive and negative aspects, cannot fully replace each other, and the data obtained with their help are not always the same. It should be taken into account that neither instrumental method has absolute diagnostic accuracy.