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初次经皮冠状动脉介入治疗后早期使用双嘧达莫药物负荷试验行心肌灌注闪烁显像检查中可逆性缺陷的发生率:实施该方案有多安全?

Incidence of reversible defect seen on myocardial perfusion scintigraphy using dipyridamole pharmacologic test early after primary percutaneous coronary intervention: how safe is it to perform this protocol?

机构信息

Third Department of Nuclear Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Greece.

出版信息

Hellenic J Cardiol. 2014 Nov-Dec;55(6):492-8.

Abstract

INTRODUCTION

The purpose of this study was to investigate the safety of performing a dipyridamole stress test and to explore the incidence of reversible perfusion defects on myocardial perfusion imaging, five to six days after primary percutaneous coronary intervention (PCI).

METHODS

Forty-one patients underwent myocardial perfusion imaging using a dipyridamole stress test, five to six days after primary PCI.

RESULTS

Headache, chest pain, and dizziness were the most common side effects seen after dipyridamole administration. All occurrences were mild and short lasting. ST changes on the electrocardiogram were also seen in 12% of patients. Reversible perfusion defects occurred in 17%.

CONCLUSIONS

This is one of the few studies to investigate patients using a dipyridamole stress test early after primary PCI. We conclude that it is safe to perform myocardial perfusion imaging under dipyridamole administration, just a few days after primary PCI. Additionally, a high incidence (17%) of myocardial perfusion defects was seen in this group of patients. According to our investigational protocol, a second myocardial perfusion imaging examination is scheduled for six months later, in order to clarify how many of these patients suffer from restenosis, or whether the finding was merely due to early endothelial dysfunction.

摘要

简介

本研究旨在探讨在经皮冠状动脉介入治疗(PCI)后 5 至 6 天进行双嘧达莫负荷试验的安全性,并探讨心肌灌注成像中可逆性灌注缺陷的发生率。

方法

41 例患者在经皮冠状动脉介入治疗后 5 至 6 天进行了双嘧达莫负荷试验心肌灌注成像。

结果

头痛、胸痛和头晕是双嘧达莫给药后最常见的副作用。所有不良反应均为轻度和短暂的。12%的患者心电图出现 ST 段改变。17%的患者出现可逆性灌注缺陷。

结论

这是少数几项在经皮冠状动脉介入治疗后早期使用双嘧达莫负荷试验的研究之一。我们得出结论,在经皮冠状动脉介入治疗后几天内,在双嘧达莫给药下进行心肌灌注成像安全。此外,该组患者的心肌灌注缺陷发生率较高(17%)。根据我们的研究方案,计划在 6 个月后进行第二次心肌灌注成像检查,以明确这些患者中有多少人患有再狭窄,或者该发现是否仅仅是由于早期内皮功能障碍。

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