Wilson R A, Okada R D, Boucher C A, Strauss H W, Pohost G M
Am J Cardiol. 1983 Mar 1;51(5):741-8. doi: 10.1016/s0002-9149(83)80125-8.
Exercise-induced increases in radionuclide-determined pulmonary blood volume (PBV) and thallium lung uptake have been described in patients with coronary artery disease (CAD) and have been shown to correlate with transient exercise-induced left ventricular dysfunction. To compare these 2 techniques in the same patients, 74 patients (59 with and 15 without significant CAD) underwent supine bicycle exercise twice on the same day--first for thallium myocardial and lung imaging and then for technetium-99m gated blood pool imaging for the PBV ratio determination. Thallium activity of lung and myocardium was determined to calculate thallium lung/heart ratio. Relative changes in PBV from rest to exercise were expressed as a ratio of pulmonary counts (exercise/rest). Previously reported normal ranges for thallium lung/heart ratio and PBV ratio were used. The PBV ratio and thallium lung/heart ratio were abnormal in 71 and 36%, respectively, of patients with CAD (p less than 0.01). Both ratios were normal in all patients without CAD. Although the resting ejection fractions did not differ significantly in patients with normal versus those with abnormal PBV ratios or thallium lung/heart ratios, abnormal PBV ratios and thallium lung/heart ratios were associated with an exercise-induced decrease in ejection fraction. Propranolol use was significantly higher in patients with abnormal than in those with normal thallium lung/heart ratios (p less than 0.01). No significant difference in propranolol use was present in patients with abnormal or normal PBV ratios.
(1) the prevalence of an abnormal thallium lung/heart ratio is less than that of the PBV ratio in patients with CAD; (2) both tests are normal in normal control subjects; (3) propranolol does not cause abnormal results in normal control subjects; however, propranolol may influence lung thallium uptake in patients with CAD; and (4) when both tests are abnormal, there is a high likelihood of multivessel disease.
已有研究描述了冠心病（CAD）患者运动诱导的放射性核素测定肺血容量（PBV）增加和铊肺摄取增加，并表明其与运动诱导的短暂左心室功能障碍相关。为了在同一患者中比较这两种技术，74例患者（59例有显著CAD，15例无显著CAD）在同一天进行了两次仰卧位自行车运动——首先进行铊心肌和肺显像，然后进行锝-99m门控血池显像以测定PBV比值。测定肺和心肌的铊活性以计算铊肺/心比值。从静息到运动时PBV的相对变化表示为肺计数的比值（运动/静息）。使用先前报道的铊肺/心比值和PBV比值的正常范围。CAD患者中PBV比值和铊肺/心比值分别有71%和36%异常（p<0.01）。所有无CAD的患者这两个比值均正常。虽然静息射血分数在PBV比值或铊肺/心比值正常与异常的患者中无显著差异，但异常PBV比值和铊肺/心比值与运动诱导的射血分数降低相关。铊肺/心比值异常的患者使用普萘洛尔的比例显著高于比值正常的患者（p<0.
