Elliott M D, Holly T A, Leonard S M, Hendel R C
Department of Medicine, Northwestern University Medical School, Chicago, Ill, USA.
J Nucl Cardiol. 2000 Nov-Dec;7(6):584-9. doi: 10.1067/mnc.2000.108737.
Limited data are available about the effects of adjunctive treadmill exercise on adverse effects and the image quality of adenosine perfusion imaging. This study compared the incidence of adverse effects and image quality between standard 6-minute adenosine perfusion imaging and a stress test incorporating a 4-minute adenosine infusion with low-level treadmill exercise.
Nineteen patients underwent both a 6-minute adenosine technetium-99m sestamibi single photon emission computed tomography (SPECT) imaging study and a 4-minute adenosine Tc-99m sestamibi SPECT study with 6 minutes of simultaneous low-level treadmill exercise. Symptoms were recorded at 1-minute intervals during the stress and recovery periods. Heart-to-liver and heart-to-lung count ratios were determined from anterior planar images. More adverse effects were experienced during the standard adenosine study than during the adenosine study with low-level exercise (2.7+/-1.4 vs. 1.4+/-1.1, P = .0003). The duration adverse effects were experienced was longer during the standard 6-minute adenosine protocol (6.6+/-2.1 minutes vs 3.2+/-2.8 minutes, P<.0001). Additionally, the symptom-severity scores were higher with the standard adenosine study (15.5+/-9.8 vs 4.5+/-5.1, P<.0001). The heart-to-liver ratios were noted to be higher in the 4-minute adenosine protocol with low-level exercise (1.0+/-0.3 vs. 0.6+/-0.2, P = .0003).
In comparison with standard 6-minute adenosine perfusion imaging, a protocol incorporating a 4-minute adenosine infusion with low-level treadmill exercise results in a marked reduction in the quantity and severity of adverse effects and an improvement in image quality.
关于辅助跑步机运动对腺苷灌注成像的不良反应及图像质量影响的数据有限。本研究比较了标准6分钟腺苷灌注成像与结合4分钟腺苷输注及低水平跑步机运动的负荷试验之间的不良反应发生率及图像质量。
19例患者分别接受了6分钟的腺苷锝-99m甲氧基异丁基异腈单光子发射计算机断层扫描（SPECT）成像研究以及4分钟腺苷锝-99m甲氧基异丁基异腈SPECT研究，同时进行6分钟的低水平跑步机运动。在负荷期和恢复期，每隔1分钟记录症状。从前位平面图像确定心-肝和心-肺计数比。标准腺苷研究期间出现的不良反应比低水平运动的腺苷研究更多（2.7±1.4对1.4±1.1，P = .0003）。标准6分钟腺苷方案期间不良反应持续的时间更长（6.6±2.1分钟对3.2±2.8分钟，P<.0001）。此外，标准腺苷研究的症状严重程度评分更高（15.5±9.8对4.5±5.1，P<.0001）。在4分钟腺苷方案结合低水平运动时，心-肝比更高（1.0±0.3对0.6±0.2，P = .0003）。
与标准6分钟腺苷灌注成像相比，结合4分钟腺苷输注及低水平跑步机运动的方案可显著减少不良反应的数量和严重程度，并改善图像质量。
