Effect of antianginal medication on resting myocardial perfusion and pharmacologically induced hyperemia
| Autor: | Torsten Toftegaard Nielsen, Flemming Randsbæk, Morten Bøttcher, Jens Refsgaard, Hans Erik Bøtker, Anne Kaltoft, Mette Madsen |
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| Předmět: |
Male
Nitroglycerin/administration & dosage medicine.medical_treatment Perfusion scanning Coronary Artery Disease Percutaneous coronary intervention Nitroglycerin Metoprolol/administration & dosage Medicine Drug Interactions Carbon Radioisotopes Metoprolol medicine.diagnostic_test Hyperemia/chemically induced Heart Dipyridamole Middle Aged Heart/diagnostic imaging Coronary Vessels Anesthesia Cardiology Female Cardiology and Cardiovascular Medicine Perfusion medicine.drug Coronary Artery Disease/complications Quality Control medicine.medical_specialty Hyperemia Sensitivity and Specificity Angina Pectoris/drug therapy Angina Pectoris Myocardial perfusion Myocardial perfusion imaging Ammonia Internal medicine Humans Radiology Nuclear Medicine and imaging Amlodipine Radionuclide Imaging Amlodipine/administration & dosage Coronary Vessels/drug effects business.industry Reproducibility of Results Discontinuation Regimen business |
| Zdroj: | Aarhus University Bøttcher, M, Refsgaard, J, Madsen, M M, Randsbæk, F, Kaltoft, A, Bøtker, H E & Nielsen, T T 2003, ' Effect of antianginal medication on resting myocardial perfusion and pharmacologically induced hyperemia ', Journal of Nuclear Cardiology, vol. 10, no. 4, pp. 345-352 . https://doi.org/10.1016/s1071-3581(03)00454-9 Bøttcher, M, Refsgaard, J, Madsen, M M, Randsbæk, F, Kaltoft, A, Bøtker, H E & Nielsen, T T 2000, ' Effect of antianginal medication on resting myocardial perfusion and pharmacologically induced hyperemia ', Journal of Nuclear Cardiology, vol. 10, pp. E001-E008 . Bøttcher, M, Refsgaard, J, Madsen, M M, Randsbæk, F, Kaltoft, A, Bøtker, H E & Nielsen, T T 2003, ' Effect of antianginal medication on resting myocardial perfusion and pharmacologically induced hyperemia ', Journal of Nuclear Cardiology, vol. 10, no. 4, pp. 345-352 . https://doi.org/10.1016/S1071-3581(03)00454-9 Bøttcher, M, Refsgaard, J, Madsen, M M, Randsbaek, F, Kaltoft, A, Bøtker, H E & Nielsen, T T 2003, ' Effect of antianginal medication on resting myocardial perfusion and pharmacologically induced hyperemia ', Journal of Nuclear Cardiology, vol. 10, no. 4, pp. 345-52 . https://doi.org/10.1016/s1071-3581(03)00454-9 |
| DOI: | 10.1016/s1071-3581(03)00454-9 |
| Popis: | BACKGROUND: Patients scheduled for myocardial perfusion imaging are often taking several antianginal drugs. There is presently no consensus concerning a regimen of discontinuation before either rest or pharmacologic stress myocardial perfusion imaging. Whether antianginal treatment affects diagnostic sensitivity and specificity is not well documented. Methods and results The effect of the three most commonly used antianginal drugs (nitroglycerin, 400 microg [NTG]; metoprolol, 50 mg [MET]; and amlodipine, 5 mg [AML]) on myocardial perfusion was tested in 49 patients (age, 63 +/- 8 years; 43 men) allocated prospectively to one of the treatments (NTG, n = 25; MET, n = 14; and AML, n = 10). All patients had documented coronary artery disease and were scheduled for elective percutaneous coronary intervention. Patients were studied once on treatment and once off treatment with an interval of 1 to 3 weeks. For NTG, the measurements were performed on the same day with an interval of 1 hour. The MET and AML groups were also studied during dipyridamole-induced hyperemia (0.56 mg. kg(-1). min(-1) for 4 minutes). So that a quantitative value of myocardial perfusion in milliliters per gram per minute could be obtained, myocardial perfusion was quantified with nitrogen 13 ammonia positron emission tomography as an average of the midventricular perfusion in each of the 3 vascular territories. NTG treatment increased the overall resting perfusion (0.75 +/- 0.18 vs 0.86 +/- 0.22, P CONCLUSIONS: Antianginal medication can alter both resting and hyperemic myocardial perfusion and might affect the ability to detect flow-limiting stenosis. NTG increases perfusion, MET reduces perfusion, and AML does not affect perfusion. Larger-scale trials are warranted to establish a consensus for optimal antianginal medication for patients undergoing perfusion imaging. |
| Databáze: | OpenAIRE |
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