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Exercise echocardiography after stabilization of unstable angina: Correlation with exercise thallium‐201 single photon emission computed tomography

The diagnostic usefulness of predischarge exercise echocardiography in 35 patients with unstable angina who responded to medical therapy was correlated with exercise thallium‐201 single photon emission computed tomography (TI‐SPECT) performed, on the average, three days after the exercise echocardiography. None of the patients had myocardial infarction prior to hospitalization or before TI‐SPECT and none had left bundle‐branch block on their rest electrocardiogram (ECG). Exercise echocardiography was positive in 21 patients and TI‐SPECT in 24. The results of the two techniques were concordant in 28 of 35 patients (agreement = 80%, k = 0.57±0.14, p<0.001). Wall‐by‐wall comparison of the distribution of exercise‐induced wall motion abnormalities with reversible thallium defects showed complete or partial correlation in all of 19 patients in whom both the tests were positive. A positive exercise ECG and positive exercise echocardiography identified 11 of 11 patients with angiographically verified significant coronary artery disease (CAD) and 11 of 12 patients (92%) with positive TI‐SPECT. Thus, exercise echocardiography is a valuable addition to routine predischarge exercise test in the noninvasive diagnosis of myocardial ischemia and shows a good correlation with TI‐SPECT in detecting and localizing ischemia in patients with unstable angina stabilized on medical therapy.