الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
In 2016, ischemic heart disease affected more than 153 million individuals globally and more than 2.5 million individuals in Egypt. Ischemic heart disease caused more than 9.4 million deaths globally and more than 144 thousand deaths in Egypt. This makes ischemic heart disease the most common cause of death worldwide (17.3% of all deaths).
SPECT-MPI is a well-established non-invasive imaging technique that provides both diagnostic and prognostic data regarding ischemic heart disease.
SPECT-MPI is performed during stress and rest. stress is achieved by exercise, vasodilator pharmacologic agents, or inotropic pharmacologic agents.
The aim of this study was to investigate the incidence and severity of chest pain during radionuclide myocardial perfusion imaging and its relation to the stress modality used and the findings of the radionuclide myocardial perfusion imaging.
The study design was retrospective and prospective of patients that presented to Alexandria university nuclear cardiology lab for radionuclide myocardial perfusion imaging. All patients were subjected to history taking including age, sex, risk factors, presenting complaint and its class, other medical conditions, and medications. All patients were subjected to full cardiac examination including heart rate and blood pressure.
All patients underwent SPECT-MPI and were divided into 2 groups (each of 50 patients) depending on the stress modality used. For the first group exercise stress was achieved by treadmill Bruce protocol. For the second group vasodilatation pharmacologic stress was achieved using dipyridamole (0.56 mg/kg over 4 minutes).
Analysis of SPECT-MPI details included initial and peak heart rate, initial and peak blood pressure, the incidence of chest pain and its severity using verbal rating scale, incidence of ECG changes, incidence of left ventricular dilatation, incidence of increased lung thallium uptake, and the vessel territories affected.
In this study the following results were found:
• A statistically significant higher incidence and severity of chest pain with exercise compared to dipyridamole.
• An increased incidence and severity of chest pain with the increase in the number of vessel territories affected in the dipyridamole group.
• A statistically significant higher incidence of ECG changes with exercise compared to dipyridamole.
• An increased incidence of left ventricular dilatation with the increase in the number of vessel territories affected in both groups.
• An increased incidence of increased lung thallium-201 uptake with the increase in the number of vessel territories affected in the exercise group