Lahiri A, Zanelli G D, O'Hara M J, Bowles M J, Jones R I, Cave A P, Raftery E B
Eur Heart J. 1986 Jun;7(6):493-500. doi: 10.1093/oxfordjournals.eurheartj.a062096.
The state of left ventricular function and myocardial perfusion are important determinants of prognosis in patients with coronary artery disease and information on both can be valuable for planning individual patient management. We have studied the feasibility of simultaneous measurement of left ventricular ejection fraction with ultra short-lived gold-195 m (half life 30.5 seconds) and myocardial perfusion with thallium-201, at rest and after exercise with a single-crystal gamma camera. The results with first-pass radionuclide angiocardiography (RNA) using gold-195 m at rest were reproducible and agreed closely with the results obtained using technetium-99 m equilibrium radionuclide angiocardiography (r = 0.93). Ejection fraction by first-pass gold-195 m RNA during semi-supine ergometric exercise decreased by greater than 5% in 13 out of 18 patients with coronary artery disease and stable angina. Simultaneous myocardial imaging with thallium-201 was abnormal in all patients. The change in regional wall motion abnormality score during exercise correlated with the change in myocardial perfusion (r = 0.71, P less than 0.01) and with the change in global left ventricular ejection fraction (r = 0.77, P less than 0.001). The widely differing energy levels and half-lives of gold-195 m and thallium-201 made it possible to separate clearly the images due to each radionuclide. This study has demonstrated the feasibility of simultaneous or sequential assessment of left ventricular function and myocardial perfusion during a single exercise test, a technique which can offer advantages in clinical evaluation of patients with coronary artery disease.
左心室功能状态和心肌灌注是冠心病患者预后的重要决定因素，有关这两方面的信息对于规划个体患者的治疗具有重要价值。我们研究了使用半衰期极短的金 - 195m（半衰期30.5秒）同时测量左心室射血分数以及使用铊 - 201测量静息和运动后心肌灌注的可行性，采用单晶γ相机进行检测。静息状态下使用金 - 195m进行首次通过放射性核素心血管造影（RNA）的结果具有可重复性，并且与使用锝 - 99m平衡放射性核素心血管造影获得的结果密切相关（r = 0.93）。在18例患有冠心病和稳定型心绞痛的患者中，有13例在半卧位测力计运动期间通过首次通过金 - 195m RNA测得的射血分数下降超过5%。所有患者同时进行的铊 - 201心肌显像均异常。运动期间局部室壁运动异常评分的变化与心肌灌注的变化相关（r = 0.71，P < 0.01），并且与整体左心室射血分数的变化相关（r = 0.77，P < 0.001）。金 - 195m和铊 - 201的能量水平和半衰期差异很大，使得能够清晰地分离出每种放射性核素产生的图像。本研究证明了在单次运动试验期间同时或顺序评估左心室功能和心肌灌注的可行性，该技术在冠心病患者的临床评估中具有优势。
