Watanabe S, Ajisaka R, Masuoka T, Iida K, Sugishita Y, Ito I, Takeda T, Toyama H, Akisada M
Department of Internal Medicine, University of Tsukuba.
J Cardiol. 1989 Sep;19(3):657-65.
The value of exercise thallium scintigraphy in detecting coronary artery disease is well established. However, there are at times situations in which the exercise test cannot be readily used. Isoproterenol (ISP) stress ECG (ISP-ECG) is reportedly a useful method in diagnosing coronary artery disease. In the present study, we assessed the diagnostic value of ISP thallium scintigraphy, comparing it with those of ISP-ECG and exercise thallium scintigraphy. The study population consisted of 24 patients who had histories of chest pain without previous myocardial infarction. ISP was given at increasing doses of 0.02, 0.04, 0.08 micrograms/kg/min at 3-minute intervals, and was terminated for any of the following reasons: angina, significant arrhythmia, significant ST segment depression (greater than or equal to 0.1 mV) or target heart rate. Thallium scintigrams were obtained immediately after terminating ISP infusion, and after a 3-hour delay, redistribution scans were obtained. Scintigrams were considered positive when a reversible defect was present. In nine patients who underwent exercise tests, exercise thallium scintigraphy was also performed. After the stress tests, coronary angiography was performed. According to the presence or absence of significant coronary artery stenosis (greater than or equal to 75%), all subjects were divided into two groups: coronary artery disease (CAD) group (n = 12) and so-called normal coronary (NC) group (n = 12). 1. Among 12 patients in the CAD group, ISP induced anginal pain in six (50%), and ISP-ECG and ISP thallium scintigraphy were positive in 10 (83%) and in 11 (92%), compared with four (33%), four (33%) and two (17%) in the NC group.(ABSTRACT TRUNCATED AT 250 WORDS)
运动铊闪烁扫描术在检测冠状动脉疾病方面的价值已得到充分证实。然而，有时运动试验无法轻易进行。据报道，异丙肾上腺素（ISP）负荷心电图（ISP-ECG）是诊断冠状动脉疾病的一种有用方法。在本研究中，我们评估了ISP铊闪烁扫描术的诊断价值，并将其与ISP-ECG和运动铊闪烁扫描术的诊断价值进行比较。研究对象包括24例有胸痛病史且既往无心肌梗死的患者。以0.02、0.04、0.08微克/千克/分钟的递增剂量每隔3分钟给予ISP，若出现以下任何一种情况则终止：心绞痛、严重心律失常、显著ST段压低（大于或等于0.1毫伏）或达到目标心率。在终止ISP输注后立即进行铊闪烁扫描，并在延迟3小时后进行再分布扫描。当存在可逆性缺损时，闪烁扫描被视为阳性。在9例接受运动试验的患者中，也进行了运动铊闪烁扫描术。在负荷试验后，进行冠状动脉造影。根据是否存在显著冠状动脉狭窄（大于或等于75%），将所有受试者分为两组：冠状动脉疾病（CAD）组（n = 12）和所谓的正常冠状动脉（NC）组（n = 12）。1. 在CAD组的12例患者中，ISP诱发心绞痛6例（50%），ISP-ECG和ISP铊闪烁扫描术的阳性率分别为10例（83%）和11例（92%），而NC组分别为4例（33%）、4例（33%）和2例（17%）。（摘要截断于250字）
