Mahmarian J J, Moyé L A, Verani M S, Bloom M F, Pratt C M
Department of Internal Medicine, Baylor College of Medicine, Houston, USA.
Am J Cardiol. 1995 Jun 1;75(16):1116-9. doi: 10.1016/s0002-9149(99)80741-3.
The purpose of this study was to define the reproducibility of sequential quantitative exercise thallium-201 tomography. This was an ancillary study of a randomized, double-blind, placebo-controlled trial evaluating the short-term efficacy of transdermal nitroglycerin patches in stable patients with angiographic coronary artery disease and no prior myocardial infarction. All 18 patients had a baseline tomographic perfusion defect involving > or = 5% of the left ventricle after treadmill exercise. At a minimum of 3 days (mean 6.1 +/- 1.8) after double-blind randomization to placebo, exercise thallium-201 tomography was repeated (study 2) using the same exercise protocol as in the baseline study (study 1). No significant differences in exercise parameters were observed from studies 1 to 2. Seventeen of 18 patients (94%) had an abnormal repeat exercise perfusion scan and 96% of initially abnormal vascular territories remained abnormal. The mean tomographic perfusion defect size was not significantly different from studies 1 (17.4 +/- 13.3%) to 2 (16.6 +/- 15.3%), nor were the components defined as scar and ischemia. A > or = 10% change in total perfusion defect size in an individual patient defined the 95% confidence interval for exceeding the variability of the tomographic technique. Quantitative exercise thallium-201 tomography is highly reproducible and can be used to accurately interpret temporal changes in myocardial perfusion in individual patients.
本研究的目的是确定连续定量运动铊-201断层扫描的可重复性。这是一项辅助研究，该研究是一项随机、双盲、安慰剂对照试验，旨在评估经皮硝酸甘油贴片对患有血管造影证实的冠心病且无既往心肌梗死的稳定患者的短期疗效。所有18例患者在平板运动后基线断层扫描灌注缺损累及左心室的≥5%。在双盲随机分配至安慰剂组后至少3天（平均6.1±1.8天），采用与基线研究（研究1）相同的运动方案重复进行运动铊-201断层扫描（研究2）。研究1至2的运动参数未观察到显著差异。18例患者中有17例（94%）重复运动灌注扫描异常，最初异常的血管区域中有96%仍为异常。断层扫描灌注缺损的平均大小在研究1（17.4±13.3%）至研究2（16.6±15.3%）之间无显著差异，定义为瘢痕和缺血的成分也无显著差异。个体患者总灌注缺损大小≥10%的变化定义了超过断层扫描技术变异性的95%置信区间。定量运动铊-201断层扫描具有高度可重复性，可用于准确解释个体患者心肌灌注的时间变化。
