| Autor: |
CRAMER, M. J.M., VERZIJLBERGEN, J. F., WALL, E. E. VAN DER, VERMEERSCH, P. H., NIEMEYER, M. G., ZWINDERMAN, A. H., ASCOOP, C. A., PAUWELS, E. K.J. |
| Zdroj: |
Nuclear Medicine Communications; February 1996, Vol. 17 Issue: 2 p97-104, 8p |
| Abstrakt: |
Intravenously administered adenosine and high-dose dipyridamole, both combined with low-level exercise stress, were compared in a head-to-head fashion using 99Tcm-methoxyisobutyl isonitrile (99Tcm-MIBI) single photo emission tomography (SPET) myocardial perfusion imaging. Thirty-nine consecutive patients who had undergone coronary arteriography underwent 99Tcm-MIBI (740 Mbq) SPET after dipyridamole (0.84 mg kg-1) and after adenosine (0.84 mg kg-1), both combined with low-level exercise (30 W load), and under resting conditions. Our results demonstrate that adenosine and dipyridamole combined with exercise have comparable haemodynamic effects, with a low incidence of side-effects. The time of recovery from the stress protocol was not significantly different: adenosine, 5.7 ± 3.9 min; dipyridamole, 6.6 ± 4.9 min. However, aminophylline was significantly (P< 0.05) more often administered to reverse side-effects using the dipyridamole protocol (36 of patients) compared with the adenosine protocol (8 of patients). The results of 99Tcm-MIBI SPET imaging were highly concordant and demonstrated a high diagnostic accuracy for identifying coronary artery disease (CAD). The sensitivity was 90 (95 confidence intervals 79–100) with adenosine SPET and 93 (95 confidence intervals 84–100) with dipyridamole SPET for identifying patients with CAD (i.e. luminal stenosis > 50); their specificities were both 100 (95 confidence intervals 66–100). The sensitivity of identifying angiographically diseased vessels was 81 (95 confidence intervals 70–92) using adenosine SPET and 85 (95 confidence intervals 75–95) using dipyridamole; the specificity for both stress modalities was 94 (95 confidence intervals 89–100). The combination of exercise with adenosine and high-dose dipyridamole appears to be a feasible and safe method to alleviate some of the undesirable Al -receptor-mediated side-effects of adenosine. The choice of the pharmacological stress will depend on local expertise and availability. |
| Databáze: |
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