Hamashige N, Doi Y, Yonezawa Y, Kuzume O, Odawara H, Chikamori T, Ozawa T
Department of Medicine and Geriatrics, Kochi Medical School, Nankoku.
J Cardiol. 1989 Sep;19(3):667-78.
To detect coronary artery disease (CAD) noninvasively and to predict the occurrence of future cardiac events, 671 patients were evaluated using dipyridamole perfusion scintigraphy. 1. Although chest pain and ST depression were induced by the administration of dipyridamole in 34% and 22% of the patients, respectively, and additional intravenous aminophylline was needed in 19% of the patients, dipyridamole perfusion scintigraphy could be completed in nearly all patients. In contrast, treadmill exercise test was not accomplished in 24% of the patients. 2. The patients were classified in three groups by scintigraphic perfusion defects; i.e., group I (322 patients) with fixed defects, group II (107 patients) with reversible defects, and group III (242 patients) without perfusion defects. The patients in Group I were subclassified three groups according to three high risk parameters (extensive fixed defect, partial redistribution and diffuse slow washout)--group Ia (69 patients) with two or more high risk parameters, group Ib (144 patients) with one high risk parameter and group Ic (109 patients) without high risk parameters. 3. Coronary angiography performed in 377 patients revealed significant CAD (luminal narrowing greater than or equal to 50%) in 96%, 89%, 56%, 90% and 8% of the patients in groups Ia, Ib, Ic, II and III, respectively. Multi-vessel CAD was present in 87%, 32%, 11%, 51% and 2% of the patients in each group, respectively.
为了无创检测冠状动脉疾病（CAD）并预测未来心脏事件的发生，我们使用双嘧达莫灌注闪烁扫描对671例患者进行了评估。1. 尽管分别有34%和22%的患者在给予双嘧达莫后出现胸痛和ST段压低，且19%的患者需要额外静脉注射氨茶碱，但几乎所有患者都能完成双嘧达莫灌注闪烁扫描。相比之下，24%的患者未能完成平板运动试验。2. 根据闪烁扫描灌注缺损情况将患者分为三组；即，I组（322例患者）为固定缺损，II组（107例患者）为可逆缺损，III组（242例患者）无灌注缺损。I组患者根据三个高危参数（广泛固定缺损、部分再分布和弥漫性缓慢洗脱）进一步分为三组——Ia组（69例患者）有两个或更多高危参数，Ib组（144例患者）有一个高危参数，Ic组（109例患者）无高危参数。3. 对377例患者进行的冠状动脉造影显示，Ia、Ib、Ic、II和III组患者中分别有96%、89%、56%、90%和8%存在显著CAD（管腔狭窄大于或等于50%）。每组患者中多支血管CAD的发生率分别为87%、32%、11%、51%和2%。
