双嘧达莫输注后用铊-201洗脱率评估冠状动脉疾病的严重程度——一项冠状动脉血流动力学和代谢研究。

Assessment of the severity of coronary artery disease by thallium-201 washout rate after dipyridamole infusion--a coronary hemodynamic and metabolic study.

作者信息

Tamoto S, Ishihara T, Kojima S, Hosokawa H, Ohkubo T, Ohtuji S, Fukai M, Takada K, Seki I, Ohsawa N

机构信息

First Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan.

出版信息

Jpn Circ J. 1995 Jan;59(1):11-22. doi: 10.1253/jcj.59.11.

DOI:10.1253/jcj.59.11

PMID:7752441

Abstract

This study examined the relationship between the myocardial washout rate (WR) of thallium-201 (201Tl) in dipyridamole scintigraphy and both coronary flow reserve (CFR) and myocardial lactate extraction rate (LER) after dipyridamole infusion in 31 patients with coronary artery disease (CAD) without myocardial infarction and 16 control patients. Patients with CAD demonstrated significantly lower WR (21 +/- 17 vs 43 +/- 10%, p < 0.001), lower CFR (128 +/- 82 vs 242 +/- 89%, p < 0.001) and lower LER (-2 +/- 20 vs 10 +/- 10%, p < 0.05) than did the control patients. WR was significantly correlated with CFR (r = 0.50, p < 0.001) and LER (r = 0.41, p < 0.01) in all of the patients. CAD patients with dipyridamole-induced chest pain demonstrated significantly lower WR (14 +/- 20 vs 27 +/- 12%, p < 0.05), lower CFR (97 +/- 71 vs 162 +/- 82%, p < 0.05) and lower LER (-13 +/- 21 vs 11 +/- 9%, p < 0.001) than did CAD patients without chest pain. CAD patients with dipyridamole-induced ST depression demonstrated significantly lower WR (14 +/- 20 vs 29 +/- 8%, p < 0.05), lower CFR (105 +/- 79 vs 170 +/- 73%, p < 0.05) and lower LER (-8 +/- 21 vs 11 +/- 10%, p < 0.01) than did CAD patients without ST depression. These results suggest that the myocardial washout rate of 201Tl after dipyridamole infusion reflects the severity of coronary artery disease as assessed by coronary hemodynamics, myocardial metabolism, symptoms and electrocardiography.

摘要

本研究在31例无心肌梗死的冠心病（CAD）患者和16例对照患者中，检测了潘生丁心肌灌注显像中铊-201（201Tl）的心肌清除率（WR）与潘生丁输注后冠状动脉血流储备（CFR）和心肌乳酸摄取率（LER）之间的关系。与对照患者相比，CAD患者的WR显著降低（21±17对43±10%，p<0.001），CFR降低（128±82对242±89%，p<0.001），LER降低（-2±20对10±10%，p<0.05）。在所有患者中，WR与CFR（r = 0.50，p<0.001）和LER（r = 0.41，p<0.01）显著相关。与无胸痛的CAD患者相比，有潘生丁诱发胸痛的CAD患者的WR显著降低（14±20对27±12%，p<0.05），CFR降低（97±71对162±82%，p<0.05），LER降低（-13±21对11±9%，p<0.001）。与无ST段压低的CAD患者相比，有潘生丁诱发ST段压低的CAD患者的WR显著降低（14±20对29±8%，p<0.05），CFR降低（105±79对170±73%，p<0.05），LER降低（-8±21对11±10%，p<0.01）。这些结果表明，潘生丁输注后201Tl的心肌清除率反映了通过冠状动脉血流动力学、心肌代谢、症状和心电图评估的冠状动脉疾病的严重程度。