[Simultaneous evaluation of the myocardial perfusion and contraction for cardiac scintigraphy synchronized to the electrocardiogram for the differential diagnosis of dilated cardiomyopathy and the ischemic ventricular damage]. / Evaluación simultánea de la perfusión y contracción miocárdica por gammagrafía cardiaca para el diagnóstico diferencial de la miocardiopatía dilatada y el daño ventricular isquémico.

OBJECTIVE: We evaluated the precision of the perfusion and ventricular function through cardiac scintigraphy 99mTc-MIBI SPECT synchronized to the electrocardiogram to differentiate the ventricular damage of ischemic origin from the dilated cardiomyopathy. METHODS: Thirty patients with myocardial damage with ejection fraction =30% were included. We analyzed the prognostic value of clinical, angiographic, and 99mTc-MIBI SPECT variables. RESULTS: We studied 30 patients with myocardial damage, 26 men (86.7%) and 4 women (13.3%), with an average age of 45.7 +/- 9.3 years. The diagnosis established by cardiac catheterization was dilated cardiomyopathy in 17 patients (56.6%) and 13 with ischemic cardiomyopathy (43.4%). The study by cardiac scintigraphy 99mTc-MIBI SPECT synchronized to the electrocardiogram established the diagnosis of dilated cardiomyopathy in 18 patients, with a sensitivity of 100% and specificity of 92%. The predictive positive value was 100% and the predictive negative value 94.4%. CONCLUSIONS: Cardiac scintigraphy 99mTc-MIBI SPECT synchronized to the electrocardiogram differs in the etiology of the myocardial damage produced by dilated cardiomyopathy from that of ischemic origin in a noninvasive way and with high sensitivity and specificity.