Polar map interpretation of coronarography, echocardiography and SPECT for "holistic" evaluation of cardiological investigations

Access (Microsoft Office)-based software was developed to register the results of different cardiological investigations (echocardiography, coronarography and SPECT) in 16 left ventricular segments in a polar map display in order to compare the anatomical and functional data. Ten patients with previous myocardial infarction were selected (mean age: 48 years, EF: 36.1/spl plusmn/7.2%). They had 14 totally or subtotally occluded coronary branches. The overlap between the occlusion-associated regions derived by angiography and the corresponding defects on MIBI SPECT, and also the echocardiographic segmental wall motion scores were evaluated. The distribution of the total of 160 segments with rest perfusion defects on MIBI SPECT and the wall motion abnormalities detected by echocardiogaphy gave positive and negative predictive values of coronary occlusion of 0.94 and 0.81 against SPECT and 0.82 and 0.76 against echocardiography, respectively. Further analysis revealed that the relative MIBI activities of the individual segments correlated significantly with the wall motion scores (r=-0.87). It is concluded that the direct comparison of tomographic imaging and echocardiography with the angiogram on the polar map display in order to measure the functional consequences of coronary artery disease may help to indicate an intervention on an individual coronary lesion.