Department of Emergency, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
J Xray Sci Technol. 2021;29(2):347-360. doi: 10.3233/XST-200803.
To further investigate the clinical significance of transient ischemic dilation (TID) on myocardial perfusion imaging (MPI) by analyzing the effect of anisodamine hydrobromide (a drug that can effectively ameliorate microcirculation) on the patients with isolated TID and the findings of previous literatures.
Total 107 patients with isolated TID (TID value≥1.11) were randomly divided into group A (n = 36; intravenous administration of anisodamine hydrobromide), group N (n = 36; intravenous administration of isosorbide dinitrate), and group C (n = 35; intravenous administration of normal saline). MPI and treadmill exercise test (TET) were performed again after 14-day course of intervention. Pre- and post-intervention frequencies of symptom were recorded.
In group A, after intervention of anisodamine hydrobromide, the summed stress score (SSS) and TID value on MPI significantly decreased than those before intervention (P < 0.001), the durations of exercise (DEs) and metabolic equivalents (METs) in TET notably ascended (P < 0.001), as well as the symptom remarkably improved. In group N and group C, there were no significant differences in SSS, TID value, DEs, METs, and frequencies of symptom between pre- and post-intervention (P > 0.05). No significant improvement of symptoms in group N before and after treatment.
TID with perfusion defect may usually predict a possibility of severe and extensive coronary artery disease (CAD). An isolated TID should be considered as a likelihood of coronary microvascular dysfunction (CMD). TET and coronary CT angiography (cCTA) are extremely helpful for the antidiastole on CAD and CMD. The administration of anisodamine hydrobromide might be an optional treatment for the patients with isolated TID.
通过分析山莨菪碱（一种可有效改善微循环的药物）对孤立性心肌灌注显像（MPI）中短暂性缺血扩张（TID）患者的影响及其以往文献的发现，进一步探讨 TID 在 MPI 中的临床意义。
共 107 例孤立性 TID（TID 值≥1.11）患者随机分为 A 组（n = 36；静脉注射山莨菪碱氢溴酸盐）、N 组（n = 36；静脉注射硝酸异山梨酯）和 C 组（n = 35；静脉注射生理盐水）。干预 14 天后再次进行 MPI 和跑步机运动试验（TET）。记录干预前后症状的发生频率。
A 组患者静脉注射山莨菪碱氢溴酸盐后，MPI 上的总和应激评分（SSS）和 TID 值明显低于干预前（P < 0.001），TET 中的运动时间（DEs）和代谢当量（METs）明显升高（P < 0.001），症状明显改善。N 组和 C 组患者干预前后 SSS、TID 值、DEs、METs 和症状发生频率无明显差异（P > 0.05）。N 组患者治疗前后症状无明显改善。
伴有灌注缺损的 TID 可能通常预示着严重和广泛的冠状动脉疾病（CAD）的可能性。孤立性 TID 应被视为冠状动脉微血管功能障碍（CMD）的可能性。TET 和冠状动脉 CT 血管造影（cCTA）对 CAD 和 CMD 的舒张期非常有帮助。山莨菪碱氢溴酸盐的给药可能是治疗孤立性 TID 患者的一种可选方法。
