Okada R D, Bendersky R, Strauss H W, Pohost G M, Boucher C A
Am Heart J. 1987 Sep;114(3):524-31. doi: 10.1016/0002-8703(87)90748-4.
Sixty-eight patients underwent dipyridamole thallium imaging and exercise blood pool imaging in order to determine the functional significance of various dipyridamole thallium imaging redistribution patterns. Serial thallium images and blood pool regional wall motion were interpreted by three independent observers. Rest and exercise left ventricular ejection fractions were calculated by two observers and were averaged. Transient thallium defects were associated with normal rest and exercise left ventricular ejection fraction and regional wall motion. Mild persistent thallium defects were associated with normal ejection fraction and regional wall motion at rest, with a deterioration in both with exercise. Severe persistent thallium defects were associated with reduced ejection fraction and regional wall motion at rest, but no further deterioration with exercise. These data support the following postulates: Transient dipyridamole thallium defects are due to mild coronary artery stenoses that cause no detectable functional consequence during levels of exercise achieved in this study. Mild persistent defects are due to more severe stenoses that do cause a functional reduction in wall motion during exercise. Although appearing qualitatively persistent, these defects probably represent very slow thallium redistribution and ischemia rather than scar. Finally, severe persistent defects probably represent myocardial scar.
68例患者接受了双嘧达莫铊显像和运动血池显像，以确定各种双嘧达莫铊显像再分布模式的功能意义。连续的铊显像和血池局部室壁运动由三名独立的观察者进行解读。两名观察者计算静息和运动时的左心室射血分数并取平均值。短暂性铊缺损与静息和运动时正常的左心室射血分数及局部室壁运动相关。轻度持续性铊缺损与静息时正常的射血分数和局部室壁运动相关，但运动时两者均恶化。重度持续性铊缺损与静息时射血分数降低和局部室壁运动减弱相关，但运动时无进一步恶化。这些数据支持以下假设：短暂性双嘧达莫铊缺损是由于轻度冠状动脉狭窄所致，在本研究达到的运动水平期间未引起可检测到的功能后果。轻度持续性缺损是由于更严重的狭窄所致，在运动时确实会导致室壁运动功能降低。尽管这些缺损在定性上表现为持续性，但它们可能代表铊的非常缓慢的再分布和缺血而非瘢痕。最后，重度持续性缺损可能代表心肌瘢痕。
