Okada R D, Glover D K, Leppo J A
Saint Francis Hospital Medical Research Institute, University of Oklahoma Health Sciences Center, Tulsa 74136.
Circulation. 1991 Sep;84(3 Suppl):I132-9.
Dipyridamole 201Tl imaging has been proposed as an alternative to exercise ECG testing for the prehospital discharge evaluation of patients recovering from myocardial infarction. The rationale is that many postinfarction patients with exercise-induced ischemia experience later cardiac events, and the sensitivity of predischarge exercise ECG testing in patients with multivessel disease ranges from only 45% to 62%. In addition, several groups of investigators have shown the sensitivity of submaximum exercise 201Tl imaging to be less than ideal. This report summarizes the current status of dipyridamole 201Tl imaging in the period of 1-13 days after myocardial infarction. Although the number of studies performed to date is limited, the following conclusions can be drawn: dipyridamole 201Tl imaging after myocardial infarction was associated with no serious side effects, and those present could be quickly reversed with aminophylline; redistribution with dipyridamole 201Tl images definitely correlates with prognosis after uncomplicated myocardial infarction; dipyridamole 201Tl imaging is definitely useful in patients unable to exercise for a variety of reasons; and future studies are definitely indicated to further define the role of dipyridamole 201Tl imaging for assessing prognosis, especially in those patients undergoing interventional therapy after acute myocardial infarction.
双嘧达莫201铊显像已被提议作为运动心电图测试的替代方法，用于心肌梗死康复患者的院前出院评估。其基本原理是，许多有运动诱发缺血的心肌梗死后患者会发生后期心脏事件，且多支血管病变患者出院前运动心电图测试的敏感性仅在45%至62%之间。此外，几组研究人员已表明次极量运动201铊显像的敏感性并不理想。本报告总结了心肌梗死后1至13天期间双嘧达莫201铊显像的现状。尽管迄今为止进行的研究数量有限，但可得出以下结论：心肌梗死后双嘧达莫201铊显像未出现严重副作用，出现的副作用可用氨茶碱迅速逆转；双嘧达莫201铊图像的再分布与单纯性心肌梗死后的预后肯定相关；双嘧达莫201铊显像对因各种原因无法运动的患者肯定有用；肯定需要进一步开展研究以进一步明确双嘧达莫201铊显像在评估预后中的作用，尤其是在急性心肌梗死后接受介入治疗的患者中。
