Weiss A T, Tzivoni D, Sagie A, Atlan H, Lewis B S, Warshaw D, Gotsman M S
Isr J Med Sci. 1983 Jun;19(6):495-504.
A study was undertaken to examine the value of rapid atrial pacing and thallium-201 scintigraphy in the evaluation of ischemic heart disease. Ten subjects with angiographically normal coronary arteries and 31 patients with coronary artery disease were studied. Six of these patients were studied after coronary artery bypass surgery. Coronary ischemia or infarction could be diagnosed from the ECG alone (rest and atrial pacing) in 87% of the patients with a greater than or equal to 50% narrowing of a coronary artery. The ECG and scintiscan (at rest and pacing) together had a sensitivity of 100%. The ECG could not identify the site of stress-induced ischemia. Rapid atrial pacing with scintigraphy identified 91% of those patients with a right coronary artery narrowing (greater than 50%), 85% with a narrowing of the left anterior descending coronary artery, but only 33% with a narrowing of the circumflex coronary artery. The scintiscan correctly identified 40% of arteries with a 50 to 89% narrowing, 75% with a 90 to 99% narrowing and 88% with a complete obstruction. The scintiscan predicted single- and double-vessel disease, but underestimated the number of vessels involved in patients with triple-vessel disease. This technique was also useful in assessing the patency of implanted coronary artery bypass grafts. Rapid atrial pacing is a simple and safe method of inducing ischemia, while thallium scintigraphy shows the site, extent and severity of coronary artery disease.
开展了一项研究，以检验快速心房起搏和铊 - 201闪烁扫描术在评估缺血性心脏病中的价值。对10名冠状动脉造影显示正常的受试者和31名冠心病患者进行了研究。其中6名患者在冠状动脉搭桥手术后接受了研究。在冠状动脉狭窄大于或等于50%的患者中，87%可仅通过心电图（静息和心房起搏时）诊断出冠状动脉缺血或梗死。心电图和闪烁扫描（静息和起搏时）联合使用的敏感性为100%。心电图无法确定应激性缺血的部位。快速心房起搏联合闪烁扫描术可识别出91%右冠状动脉狭窄（大于50%）的患者、85%左前降支冠状动脉狭窄的患者，但仅能识别出33%回旋支冠状动脉狭窄的患者。闪烁扫描术能正确识别出40%狭窄50%至89%的动脉、75%狭窄90%至99%的动脉以及88%完全阻塞的动脉。闪烁扫描术可预测单支和双支血管病变，但低估了三支血管病变患者受累血管的数量。该技术在评估植入的冠状动脉搭桥移植物的通畅性方面也很有用。快速心房起搏是一种简单安全的诱发缺血的方法，而铊闪烁扫描术可显示冠状动脉疾病的部位、范围和严重程度。
