Whitfield S, Aurigemma G, Pape L, Leppo J
Department of Medicine, University of Massachussetts Medical Center, Worcester 01655.
Am Heart J. 1991 May;121(5):1367-73. doi: 10.1016/0002-8703(91)90140-d.
To determine how frequently new wall-motion abnormalities that are indicative of ischemia accompany thallium redistribution, 47 consecutive patients underwent two-dimensional echocardiography during routine dipyridamole-thallium stress testing. A secondary aim of the study was to determine whether the addition of isometric handgrip exercises to the standard dipyridamole imaging protocol increased the frequency of wall-motion abnormalities or thallium redistribution. Echocardiograms and thallium scans were independently interpreted, and wall-motion abnormalities that appeared with dipyridamole, handgrip exercise, or both were compared with results of thallium imaging. Five of 24 patients with thallium redistribution had new wall-motion abnormalities, and the extent (number of segments) of thallium redistribution in these five patients was significantly greater than in those who did not have well-motion abnormalities (p less than 0.03). The addition of isometric handgrip exercises to the imaging protocol did not distinguish between patients with and without new wall-motion abnormalities or thallium redistribution. Thus new wall-motion abnormalities infrequently accompany thallium redistribution in routine dipyridamole stress testing in spite of the addition of handgrip exercises, but when new wall-motion abnormalities are present, they are associated with a greater area of thallium redistribution.
为了确定提示缺血的新的室壁运动异常伴随铊再分布的频率，47例连续患者在常规双嘧达莫 - 铊负荷试验期间接受了二维超声心动图检查。该研究的第二个目的是确定在标准双嘧达莫成像方案中加入等长握力运动是否会增加室壁运动异常或铊再分布的频率。超声心动图和铊扫描由独立人员解读，并将双嘧达莫、握力运动或两者出现时的室壁运动异常与铊成像结果进行比较。24例有铊再分布的患者中有5例出现了新的室壁运动异常，这5例患者的铊再分布范围（节段数）显著大于无室壁运动异常的患者（P<0.03）。在成像方案中加入等长握力运动并不能区分有无新的室壁运动异常或铊再分布的患者。因此，在常规双嘧达莫负荷试验中，尽管加入了握力运动，新的室壁运动异常很少伴随铊再分布，但当出现新的室壁运动异常时，它们与更大面积的铊再分布相关。
