A single-center prospective study of 153 patients with suspected or know CAD with and without chest pain has demonstrated 83% sensitivity and 83% specificity for detecting a >50% luminal diameter narrowing based on stress- induced abnormal LV contractility [54] Nuclear Medicine Ventriculography Stress radionuclide ventriculography includes measurement of the ejection fraction and assessment of regional wall motion at rest and during stress. There is no relevant literature to support nuclear medicine ventriculography in the initial evaluation of patients with chronic chest pain and a high probability of CAD with no known IHD. Rb-82 PET/CT Heart Rb-82 PET/CT heart assesses rest myocardial perfusion and stress LVEF and quantifies rest myocardial blood flow and coronary flow reserve [55,56]. PET/CT has reported a higher accuracy over conventional nuclear techniques, MPI, and viability [55,57]. The data cited below for Rb-82 PET/CT heart are for patients with known CAD, but no information is available regarding the presence or absence of chest pain in patients included in those studies. Gated Rb-82 PET/CT has shown that myocardial perfusion, stress LVEF, and ischemic LV dysfunction are prognostically important in CAD in patients with suspected or known CAD [48]. The inherent ability of Rb-82 PET/CT to collect LV function data at rest and during peak stress seems to result in improved detection of multivessel CAD with LVEF reserve assessment providing significant independent and incremental value to Rb-82 MPI for predicting the risk of future adverse events [59]. An increasing percentage of ischemia on PET-MPI is associated with an increase in the risk of cardiac events and all-cause death [59]. A single-center study of 1,432 patients with known or suspected CAD has shown that the inherent ability of Rb-82 PET/CT to collect LV function data at rest and during peak stress leads to an improved detection of multivessel CAD [58].
Chronic Chest Pain High Probability of Coronary Artery Disease PCAs. A single-center prospective study of 153 patients with suspected or know CAD with and without chest pain has demonstrated 83% sensitivity and 83% specificity for detecting a >50% luminal diameter narrowing based on stress- induced abnormal LV contractility [54] Nuclear Medicine Ventriculography Stress radionuclide ventriculography includes measurement of the ejection fraction and assessment of regional wall motion at rest and during stress. There is no relevant literature to support nuclear medicine ventriculography in the initial evaluation of patients with chronic chest pain and a high probability of CAD with no known IHD. Rb-82 PET/CT Heart Rb-82 PET/CT heart assesses rest myocardial perfusion and stress LVEF and quantifies rest myocardial blood flow and coronary flow reserve [55,56]. PET/CT has reported a higher accuracy over conventional nuclear techniques, MPI, and viability [55,57]. The data cited below for Rb-82 PET/CT heart are for patients with known CAD, but no information is available regarding the presence or absence of chest pain in patients included in those studies. Gated Rb-82 PET/CT has shown that myocardial perfusion, stress LVEF, and ischemic LV dysfunction are prognostically important in CAD in patients with suspected or known CAD [48]. The inherent ability of Rb-82 PET/CT to collect LV function data at rest and during peak stress seems to result in improved detection of multivessel CAD with LVEF reserve assessment providing significant independent and incremental value to Rb-82 MPI for predicting the risk of future adverse events [59]. An increasing percentage of ischemia on PET-MPI is associated with an increase in the risk of cardiac events and all-cause death [59]. A single-center study of 1,432 patients with known or suspected CAD has shown that the inherent ability of Rb-82 PET/CT to collect LV function data at rest and during peak stress leads to an improved detection of multivessel CAD [58].