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BACKGROUND Cardiovascular disease accounts for significant morbidity and mortality in the elderly.Data has shown that invasive clinical procedures were less used in this population due to possibly higher complication rate and acceptance difficulty.Quantitative dobutamine stress echocardiograpy（DSE） tissue doppler imaging（TDI） and 99m Tcmethoxyisobutylisonitrile （MIBI） myocardial single-photon emission computed tomography （SPECT） were both potential methods to noninvasively detect coronary artery disease（CAD）.OBJECTIVE The aim of the study is to evaluate the clinical value of DSE+TDI,and also to compare the sensitivity,specificity and diagnostic accuracy between DSE+TDI and myocardial SPECT to detect the aging patients with suspected coronary artery disease.METHODS 98 elderly patients underwent DSE+TDI and coronary angiography.Peak tissue velocity（Vpeak）,peak tissue tracking（Dpeak）,peak strain（Speak）,peak strain rating（SRpeak） were measured and analysed in echopac 8.0 workstation.40 patients also underwent ATP stress SPECT.The Results were compared to coronary angiography（CAG）.All procedures were performed in one month.RESULTS To compare with CAG,the sensitivity,specificity and accuracy of DSE+TDI for detection CAD in the elderly patients,of Vpeak,were 82.3%、61.7%、72.4%,Dpeak 82.4%、59.5%、77.4%,SRpeak 71.7%、82.2%、78%and Speak 78.6%、72.3%、74.7%respectively. And also there were different according to the different dobutamine doses.At the dobutamine dose of 20 ug/kg.min,Vpeak and Speak had achieved maximum sensitivity,specificity and accuracy.However,at the dose of 40 ug/kg.min,Dpeak and SRpeak had achived maximum. Compared with myocardial SPECT,both SRpeak and Speak had higher specificity,while all of four variables had lower sensitivity in this population.All the adverse effects during tests were mild and transient. CONCLUSION For the elderly,DSE+TDI is a viable non-invasive technique for detecting CAD and with high sensitivity.To comparing with myocardial SPECT,DSE+TDI had higher specificity and lower sensitivity for detecting CAD in this population.
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