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腺苷与瑞加腺苷在心肌动态CT灌注扫描中用于诱导应激的比较:单中心回顾性对比

Adenosine vs. regadenoson for stress induction in dynamic CT perfusion scan of the myocardium: A single‑center retrospective comparison.

作者信息

Gibarti Claudia, Murín Pavol, Huňavý Mikuláš, Koribský Roman, Urban Lukáš, Studenčan Martin, Gál Peter

机构信息

Department of Radiology, East-Slovak Institute of Cardiovascular Diseases, Inc., 040 11 Košice, Slovakia.

Department of First Department of Cardiology, East-Slovak Institute of Cardiovascular Diseases, Inc., 040 11 Košice, Slovakia.

出版信息

Exp Ther Med. 2023 Mar 16;25(5):192. doi: 10.3892/etm.2023.11891. eCollection 2023 May.

Abstract

Cardiac computed tomography (CT) angiography offers several approaches to determine the hemodynamic severity of coronary artery obstruction. Dynamic myocardial perfusion is based on serial CT imaging of contrast flow into the myocardium and calculation of absolute myocardial perfusion rates. East-Slovak Institute of Cardiovascular Diseases has been the first center in Slovakia intensively using this modern technique to increase the quality level of non-invasive diagnosis of symptomatic patients with a low to moderate pre-test probability of ischemic heart disease. The present study included 46 patients with a mean age of 64 years (33 men and 13 women). Prior to the CT study, myocardial stress was pharmacologically (adenosine, n=15 and regadenoson, n=31) induced by vasodilatation of the coronary arteries. Hemodynamic parameters (myocardial blood flow) were evaluated in all patients following successful CT perfusion without complications, allergic reaction or other severe side effects. The present study revealed that regadenoson increased the heart rate following infusion with a higher magnitude compared with adenosine. Moreover, the effect of regadenoson was independent of patient's body mass index and was associated with a lower incidence of mild adverse effects. The present study provided further clinical evidence for a more wider use of regadenoson over adenosine.

摘要

心脏计算机断层扫描(CT)血管造影提供了几种方法来确定冠状动脉阻塞的血流动力学严重程度。动态心肌灌注基于对造影剂流入心肌的连续CT成像以及绝对心肌灌注率的计算。东斯洛伐克心血管疾病研究所是斯洛伐克第一个密集使用这种现代技术的中心,以提高对缺血性心脏病预测试概率低至中等的有症状患者的无创诊断质量水平。本研究纳入了46例患者,平均年龄64岁(33例男性和13例女性)。在CT研究之前,通过冠状动脉血管扩张以药理学方式(腺苷,n = 15;瑞加腺苷,n = 31)诱导心肌应激。在所有患者成功进行CT灌注且无并发症、过敏反应或其他严重副作用后,评估血流动力学参数(心肌血流量)。本研究表明,与腺苷相比,瑞加腺苷输注后心率升高幅度更大。此外,瑞加腺苷的作用与患者的体重指数无关,且轻度不良反应发生率较低。本研究为瑞加腺苷比腺苷更广泛的应用提供了进一步的临床证据。

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