Javadi Hamid, Shariati Malihnaz, Mogharrabi Mehdi, Asli Isa Neshandar, Jallalat Sara, Hooman Aref, Seyedabadi Mohammad, Assadi Majid
Department of Nuclear Medicine, 5th Azar Hospital, Golestan University of Medical Science, Gorgan, Iran.
J Nucl Med Technol. 2010 Sep;38(3):149-52. doi: 10.2967/jnmt.109.072629. Epub 2010 Aug 19.
Dipyridamole has extensively been administered as a substitute for physical activity in cardiovascular assessment. The aim of this study was to evaluate the association of dipyridamole side effects with hemodynamic oscillations, scanning results, and electrocardiography (ECG) findings.
Overall, 590 patients referred to the nuclear medicine center for myocardial perfusion imaging were evaluated for adverse dipyridamole effects concurrent with a low level of exercise. Before and during dipyridamole infusion, the patients' vital signs, electrocardiogram, heart rate, systolic blood pressure, and diastolic blood pressure were monitored; all patients underwent stress-rest (99m)Tc-sestamibi gated SPECT using a 2-d protocol.
Eighty-eight patients (14.9%) experienced at least one side effect during dipyridamole infusion, and abnormal ECG and scan results were observed in 32.4% and 48.6% of patients, respectively. We observed a positive correlation between a higher incidence of chest discomfort, headache, and dyspnea and abnormalities on ECG and myocardial perfusion imaging. In addition, these 3 side effects were also associated with a higher postinfusion heart rate, lower preinfusion systolic blood pressure, and lower postinfusion diastolic blood pressure. There were significant differences between pre- and postinfusion heart rate, preinfusion systolic blood pressure, and postinfusion diastolic blood pressure among patients with or without side effects, whereas no significant difference was observed in any of the hemodynamic parameters between patients with normal and abnormal ECG results or myocardial perfusion imaging results.
This study demonstrated a correlation between hemodynamic variables and side effects but not with imaging findings or ECG findings.
双嘧达莫已被广泛用作心血管评估中体力活动的替代物。本研究的目的是评估双嘧达莫副作用与血流动力学振荡、扫描结果和心电图(ECG)表现之间的关联。
总体而言,对590名转诊至核医学中心进行心肌灌注显像的患者进行评估,以确定其在低水平运动时双嘧达莫的不良反应。在输注双嘧达莫之前和期间,监测患者的生命体征、心电图、心率、收缩压和舒张压;所有患者均采用二维方案进行静息-负荷(99m)锝-甲氧基异丁基异腈门控单光子发射计算机断层扫描(SPECT)。
88名患者(14.9%)在输注双嘧达莫期间至少出现一种副作用,分别有32.4%和48.6%的患者观察到心电图和扫描结果异常。我们观察到胸部不适、头痛和呼吸困难的较高发生率与心电图和心肌灌注显像异常之间存在正相关。此外,这3种副作用还与输注后较高的心率、输注前较低的收缩压和输注后较低的舒张压相关。有副作用和无副作用患者在输注前心率、输注前收缩压和输注后舒张压方面存在显著差异,而心电图结果正常和异常的患者或心肌灌注显像结果正常和异常的患者在任何血流动力学参数方面均未观察到显著差异。
本研究表明血流动力学变量与副作用之间存在相关性,但与影像学表现或心电图表现无关。