Department of Clinical and Biomedical Sciences, University of Milan.
Department of Nuclear Medicine, IRCCS MultiMedica Sesto San Giovanni, Milan.
Nucl Med Commun. 2021 Feb 1;42(2):173-181. doi: 10.1097/MNM.0000000000001303.
The aim of the present study was to assess the effects of dipyridamole on stress and rest peak filling rate in consecutive patients who showed perfusion and, or function abnormalities at Gated-SPECT. Were enrolled 96 patients (73 males (76%); mean age 71.7 ± 9.57). Forty patients (41.7%) had an history of myocardial infarction and fifty-seven (59.4%) of previous cardiac revascularization. All patients underwent a 2-day 99mTc-SestaMIBI gated perfusion SPECT protocol.
Twenty-nine (30.2%) patients showed fixed perfusion defects, 54 (56.2%) showed partially or completely reversible ones, while 13 (13.5%) showed normal perfusion but reduced LVEF. SSS was significantly higher than SRS (9.55 ± 9.29 vs. 7.10 ± 8.48; P = 0.0001). Stress peak filling rate was not significantly higher than rest peak filling rate (1.73 EDV/s ± 0.69 EDV/s vs. 1.67 EDV/s ± 0.56 EDV/s; P = 0.62). At a multivariate regression analysis, only stress peak filling rate, as independent variable, was directly correlated with myocardial ischemia (SDS) (P = 0.018). We divided patients according to SDS in those with mild (SDS < 5) and severe (SDS ≥ 5) ischemia. Stress peak filling rate was the only parameter significantly different between groups.
Stress PFR showed a better correlation with the degree of ischemia compared to the remaining perfusion and functional parameters. The direct correlation between SDS and stress PFR leads us to speculate that dipyridamole could improve diastolic function in ischemic patients.
本研究的目的是评估双嘧达莫对门控 SPECT 显示灌注和/或功能异常的连续患者的应激和静息时峰值充盈率的影响。共纳入 96 例患者（73 例男性（76%）；平均年龄 71.7 ± 9.57 岁）。40 例（41.7%）有心肌梗死病史，57 例（59.4%）有先前的心脏血运重建史。所有患者均接受了 2 天 99mTc-SestaMIBI 门控灌注 SPECT 方案。
29 例（30.2%）患者显示固定灌注缺损，54 例（56.2%）显示部分或完全可逆性灌注缺损，而 13 例（13.5%）显示正常灌注但 LVEF 降低。SSS 明显高于 SRS（9.55 ± 9.29 比 7.10 ± 8.48；P = 0.0001）。应激时峰值充盈率与静息时峰值充盈率无显著差异（1.73 EDV/s ± 0.69 EDV/s 比 1.67 EDV/s ± 0.56 EDV/s；P = 0.62）。在多变量回归分析中，只有应激时峰值充盈率作为独立变量与心肌缺血（SDS）直接相关（P = 0.018）。我们根据 SDS 将患者分为轻度（SDS < 5）和重度（SDS ≥ 5）缺血两组。应激时峰值充盈率是两组间唯一显著不同的参数。
与其他灌注和功能参数相比，应激 PFR 与缺血程度具有更好的相关性。SDS 与应激 PFR 之间的直接相关性使我们推测双嘧达莫可能改善缺血患者的舒张功能。
