Laarman G J, Bruschke A V, Verzijlbergen F J, Bal E T, van der Wall E E, Ascoop C A
Department of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands.
Eur Heart J. 1988 Nov;9(11):1206-14. doi: 10.1093/oxfordjournals.eurheartj.a062431.
To assess the feasibility and the value of thallium-201 myocardial perfusion imaging with intravenous dipyridamole in combination with low-level exercise, 81 patients with suspected or proven coronary artery disease were studied. All patients underwent coronary arteriography. Significant coronary artery disease (stenoses greater than or equal to 50%) was present in 59 patients (73%); multivessel disease (double- and triple-vessel disease) was observed in 33 patients (42%). The overall sensitivity and specificity of the test were 78% and 86%, respectively. Sensitivity and specificity for detection of multivessel disease were 70% and 92%, respectively. The sensitivity for detecting coronary artery disease in the RCA, LAD, and LCX was 74%, 82% and 48%, respectively, and the specificity was 85%, 88% and 88%, respectively. With the combined procedure no serious side effects were observed. Mild side effects like headache, vertigo and nausea were seen in 12 patients (15%). Twenty volunteers with a less than or equal to 1% likelihood of significant coronary artery disease were examined in the same manner to determine the maximal specificity of the procedure (100%). Thus, the combination of two different stress procedures (exercise testing and dipyridamole infusion) can be performed safely without serious side effects. The presence, location and extent of significant coronary artery disease can be assessed to a similar degree as with conventional exercise thallium-201 scintigraphy, which has major implications for the detection of coronary artery disease in patients who are unable to perform maximal exercise.
为评估静脉注射双嘧达莫联合低水平运动的铊-201心肌灌注显像的可行性和价值，对81例疑似或确诊为冠状动脉疾病的患者进行了研究。所有患者均接受了冠状动脉造影。59例患者（73%）存在显著冠状动脉疾病（狭窄大于或等于50%）；33例患者（42%）观察到多支血管病变（双支和三支血管病变）。该检查的总体敏感性和特异性分别为78%和86%。检测多支血管病变的敏感性和特异性分别为70%和92%。检测右冠状动脉（RCA）、左前降支（LAD）和左回旋支（LCX）冠状动脉疾病的敏感性分别为74%、82%和48%，特异性分别为85%、88%和88%。联合检查未观察到严重副作用。12例患者（15%）出现了如头痛、眩晕和恶心等轻微副作用。对20例冠状动脉疾病可能性小于或等于1%的志愿者进行了同样的检查，以确定该检查的最大特异性（100%）。因此，两种不同的负荷检查（运动试验和双嘧达莫输注）联合应用可安全进行，无严重副作用。显著冠状动脉疾病的存在、位置和范围可与传统运动铊-201闪烁显像一样进行相似程度的评估，这对于无法进行最大运动的患者检测冠状动脉疾病具有重要意义。
