Hillert M C, Narahara K A, Smitherman T C, Burden L L, Wyatt J C
West J Med. 1986 Sep;145(3):335-40.
Unstable angina usually responds to medical management. Unfortunately, a third of patients with this condition may be expected to have severe angina in the ensuing year. We tested the ability of thallium 201 imaging with submaximal exercise to identify patients who have a poor clinical prognosis after an episode of unstable angina. In all, 37 patients were evaluated with (201)TI before hospital discharge and were assessed for severity of angina over the next 12 weeks. Of these, 20 had New York Heart Association class I or II angina during follow-up, 4 of whom had defects on (201)TI imaging that showed redistribution. In 17 patients class III or IV angina developed or they suffered an acute myocardial infarction after hospital discharge, and 15/17 had reversible defects on (201)TI imaging after submaximal stress (P<.001). (201)TI scintigraphy frequently identifies areas of ischemia with only submaximal exercise in patients whose unstable angina has responded to medical therapy.
不稳定型心绞痛通常对药物治疗有反应。不幸的是，预计有三分之一患有这种疾病的患者在接下来的一年中可能会出现严重心绞痛。我们测试了次极量运动下铊201成像识别不稳定型心绞痛发作后临床预后不良患者的能力。共有37例患者在出院前接受了铊201评估，并在接下来的12周内评估了心绞痛的严重程度。其中，20例在随访期间有纽约心脏协会I级或II级心绞痛，其中4例在铊201成像上有显示再分布的缺损。17例患者在出院后发展为III级或IV级心绞痛或发生急性心肌梗死，17例中有15例在次极量负荷后铊201成像上有可逆性缺损（P<0.001）。铊201闪烁扫描术经常能在不稳定型心绞痛对药物治疗有反应的患者中，仅通过次极量运动就识别出缺血区域。
