الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
Coronary artery disease (CAD) is one of the main causes of mortality and
morbidity worldwide. Therefore, the predictive role of diagnostic tools is crucial
in terms of prevention to CAD. Although exercise testing is a well-established
noninvasive stress test for the evaluation of the patients with suspected CAD, its
sensitivity and specificity are not satisfactory (67% and 71%, respectively).
Duke treadmill score (DTS) is well recognized as a simple prognostic score
in patients with suspected coronary artery disease (CAD). It is positioned as a
valid clinical tool when clinicians need to make a decision about the
catheterization of patients with suspected CAD
The duke treadmill score (DTS) provides valuable diagnostic and prognostic
knowledge for the evaluation of the patients with suspected CAD. DTS might be
beneficial to evaluate prognosis in patients with a moderate to high-risk. DTS
calculated by using parameters including ST-segment depression, chest pain, and
exercise time [exercise time – (5 × ST deviation) – (4 × exercise angina)].
The aim of work is to reinforce the duke treadmill score of anginas during
the treadmill stress test through a comparative study between the result of SPECT
MPI study and the duke treadmill score of the suspected CAD, since many centers
and cardiology units have no capability of MPI study and eventually that improve
the early detection and the management of the high-risk cases in the limited units.
A retrospectively reviewed of the studies patients underwent stress treadmill
test MPI between January to October 2020 were consecutively included into our
study. The study will be conducted in ALFA Scan Radiology Center, Cairo,
Egypt.
Summary
62
Results:
All patients were selected according to the inclusion and exclusion
criteria:
Inclusion criteria: Patients with large perfusion defect ≥10% on semiquantitative analysis, Patients have low ,moderate and high risk Duke treadmill
score.
Exclusion criteria were:
Patients with negative SPECT myocardial perfusion imaging.
Patients with large perfusion defect ≥10% or more but with predominant scar.
Patients who had pharmacological stress test.
Abnormal basic ECG abnormalities Lt&Rt BBB,WPW etc..
For every patient the following was done: History taking for the following
data: Age, Sex, Diabetes Mellitus, Hypertension, Dyslipidemia and Smoking, all
patients who met the inclusion criteria were compared through the results of
SPECT Myocardial Perfusion Imaging and Duke score value.
Results of the current study were summarized as follows:
The mean of age, weight, height of the studied patients was (51.14±8.81 year,
91.06±14.08 kg, 170.18±7.68 cm), respectively. Most of the studied patients
(80%) were males. More than half of them (51 %) were non-smokers.
The patients were classified as low-, intermediate-, or high-risk according to the
scores (low risk DTS ≥ +5, intermediate-risk –10 ≤ DTS ≤ +4, and high-risk DTS
≤ –11). According to the DTS, patients categorized as follows, low risk
(LR);<0.5%/year, intermediate risk; 0.5% to 5%/year and high risk; >5%/year of
cardiovascular events
Summary
63
Most of the studied patients (78 %, 80 %, 93%, 61 %, 95 % and 71) hadn’t
previous interventions, obesity, previous MI, DM, Familial hypercholesterolemia
and CAD, respectively. While, (37 %, 36 % and 23%) of them had chest Pain,
HTN and dyslipidemia, respectively.
The mean resting of heart rate, SBP and DBP were (87.77±14.77, 129.90±10.68
and 80.40±5.49), respectively. Most of the studied patients (63 %) had restingelectrocardiogram. While, the mean peak of heart Rate, SBP and DBP of the
studied patients were (153.85±19.26, 156.70±12.31 and 88.40±7.88),
respectively.
The mean of duration, metabolic equivalents, duke treadmill score of the studied
patients were (390.70±138.41, 8.14±2.41, -4.6±10.51), respectively. While,
(45%) of them were in third stage of examination. Also, (64%) of them were
negative chest pain.
Age, Previous MI and previous intervention were significantly increased among
high-risk group than low and moderate risk groups (P<0.05). On the other hand,
there were no significant differences between the studied groups regarding
gender, weight, smoking, obesity, chest Pain, HTN, DM, dyslipidemia, familial
hypercholesterolemia CAD and OHD (P>0.05).
Ending stage : high risk group were earlier to discontinue the test (2nd stage
ending) unlikely the moderate and low DTS risk group. (P< 0.05). While,
duration, METS and DTS were highly significantly increased among low-risk
group than moderate and high-risk groups(P<0.001).
There was significant relation between the risk value of Duke treadmill score and
Aston summed stress score among the studied patients (P= 0.018).