Durmus-Altun Gulay, Altun Armagan, Sami Salihoglu Yavuz, Altaner Semsi, Berkada Sakir, Ozbay Gulay
Nuclear Medicine Department, Edirne, Turkey.
Int J Cardiol. 2004 Jun;95(2-3):193-7. doi: 10.1016/j.ijcard.2003.07.006.
Amiodarone is a potent antiarrhythmic agent that is limited in clinical use by its adverse effects, including potentially life threatening amiodarone-induced pulmonary toxicity (AIPT). The alteration of technetium-99m diethyltriaminepentaaceticacid (Tc-99m DTPA) radioaerosol lung clearance in AIPT was experimentally investigated.
Eighteen white New Zealand rabbits (initial weight 4.1+/-0.2 kg) were divided into two groups. AIPT group (n=13) was administered amiodarone (20 mg/kg BW) ip as a 5% aqueous solution for 6 week. The controls (n=5) were administered the same amount of 0.9% saline ip. Four rabbits of AIPT group died due to AIPT. The reminders of AIPT group (n=9) and controls underwent Tc-99m DTPA radioaerosol lung scintigraphy at the end of the treatment period. AIPT group was divided into two subgroups according to histopathologic evaluation. AIPT-I had interstitial pneumonitis (n=4) and AIPT-II had interstitial pneumonitis with fibrosis (n=5).
The mean T(1/2) values of in control, AIPT-I, and AIPT-II groups were found 54+/-4.4, 39.2+/-11.7 and 114.6+/-16.7 min, respectively. The mean T(1/2) values of Tc-99m DTPA significantly differ than other groups (X(2)=11.78, P=0.02). The significantly increased T(1/2) values was noted in AIPT-II group when compared with control (P=0.001). In contrast, AIPT-I group has significantly lower T(1/2) values than control group (P=0.03).
We suggested that Tc-99m DTPA radioaerosol inhalation lung scintigraphy provides an accurate evaluation about stage of lung toxicity and therefore may be a useful tool for the monitoring of AIPT.
胺碘酮是一种强效抗心律失常药物,但其不良反应限制了其临床应用,这些不良反应包括潜在危及生命的胺碘酮诱发的肺毒性(AIPT)。本研究对AIPT中锝-99m二乙三胺五乙酸(Tc-99m DTPA)放射性气溶胶肺清除的改变进行了实验研究。
18只白色新西兰兔(初始体重4.1±0.2 kg)分为两组。AIPT组(n=13)腹腔注射5%胺碘酮水溶液(20 mg/kg体重),持续6周。对照组(n=5)腹腔注射等量的0.9%生理盐水。AIPT组有4只兔因AIPT死亡。治疗期结束时,AIPT组剩余的9只兔和对照组接受了Tc-99m DTPA放射性气溶胶肺闪烁扫描。根据组织病理学评估,AIPT组分为两个亚组。AIPT-I有间质性肺炎(n=4),AIPT-II有间质性肺炎伴纤维化(n=5)。
对照组、AIPT-I组和AIPT-II组的平均T(1/2)值分别为54±4.4、39.2±11.7和114.6±16.7分钟。Tc-99m DTPA的平均T(1/2)值与其他组有显著差异(X(2)=11.78,P=0.02)。与对照组相比,AIPT-II组的T(1/2)值显著升高(P=0.001)。相反,AIPT-I组的T(1/2)值显著低于对照组(P=0.03)。
我们认为,Tc-99m DTPA放射性气溶胶吸入肺闪烁扫描可准确评估肺毒性阶段,因此可能是监测AIPT的有用工具。