Synergistic value of simultaneous stress dobutamine sestamibi single-photon-emission computerized tomography and echocardiography in the detection of coronary artery disease

Am Heart J. 1994 Oct;128(4):713-8. doi: 10.1016/0002-8703(94)90269-0.


The relative value of exercise electrocardiography, simultaneous dobutamine technetium 99m-sestamibi (MIBI) single-photon-emission computerized tomography (SPECT), and echocardiography were evaluated for the diagnosis of coronary artery disease in patients with chest pain. Sixty-one consecutive patients underwent exercise electrocardiography and simultaneous graded dobutamine echocardiography and MIBI imaging. All patients underwent coronary arteriography. The exercise electrocardiogram was found to be a poor predictor of coronary artery disease (p not significant). Individually, MIBI SPECT and echocardiography were significantly predictive of coronary artery disease (p < 0.001). According to logistic regression analysis, the combined imaging modalities significantly increased the prediction of coronary artery disease for any vessel (p < 0.001), for multiple vessels (p < 0.001), and for the left anterior descending (p < 0.001), for right coronary artery (p < 0.001), and for left circumflex arteries (p < 0.01), compared with either MIBI SPECT or echocardiography alone. The results suggest a synergism in the detection of coronary artery disease when MIBI SPECT and echocardiography are combined during dobutamine stress.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Coronary Disease / diagnosis*
  • Coronary Disease / diagnostic imaging
  • Dobutamine*
  • Echocardiography*
  • Electrocardiography
  • Exercise Test
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Prognosis
  • Technetium Tc 99m Sestamibi*
  • Tomography, Emission-Computed, Single-Photon*


  • Dobutamine
  • Technetium Tc 99m Sestamibi