Shanes J G, Krone R J, Fisher K, Shah B, Eisenkramer G, Humphrey J R
Cathet Cardiovasc Diagn. 1983;9(3):271-82. doi: 10.1002/ccd.1810090306.
We administered ergonovine and used both electrocardiographic monitoring and thallium-201 [201Tl] imaging to detect reversible ischemia in 100 patients. Patients already established as having coronary artery spasm and those with nonbypassed, proximal, high-grade coronary artery stenosis were excluded. No complication occurred in any patient. The use of thallium imaging in addition to electrocardiographic monitoring resulted in a higher degree of sensitivity than did ECG monitoring alone. Fourteen patients demonstrated evidence of coronary artery spasm as documented by 201Tl imaging but of the 14, significant ECG changes occurred in only 50%, and classic ST segment elevation in 21%. Thus, in carefully selected patients the noninvasive provocation of coronary spasm can be accomplished safely, but ECG monitoring must be combined with thallium-201 imaging to achieve an acceptable degree of sensitivity.
我们对100例患者给予麦角新碱，并使用心电图监测和铊-201（201Tl）成像来检测可逆性缺血。已确诊为冠状动脉痉挛的患者以及未进行搭桥手术的近端、高度冠状动脉狭窄患者被排除在外。所有患者均未发生并发症。与单独使用心电图监测相比，联合使用铊成像和心电图监测的敏感性更高。14例患者经201Tl成像证实有冠状动脉痉挛证据，但其中只有50%出现显著心电图改变，21%出现典型ST段抬高。因此，在经过精心挑选的患者中，可以安全地进行无创性冠状动脉痉挛激发试验，但必须将心电图监测与铊-201成像相结合，以达到可接受的敏感性。
