Ferreira J, Gil V M, Ventosa A, Calqueiro J, Seabra-Gomes R
Departamento de Cardiologia Nuclear, Hospital de Santa Cruz, Carnaxide.
Rev Port Cardiol. 1995 Mar;14(3):215-24, 188.
To evaluate the accuracy and safety of pharmacologic stress testing with adenosine triphosphate (ATP) associated with thallium-201 scintigraphy for detection of coronary artery disease.
We studied 44 patients, 35 male and 9 female with a mean age of 59 + 9 years. Previous myocardial infarction was present in 15 patients. Thirty-two patients underwent coronariography that revealed coronary artery disease in 28 patients.
ATP (Stryadine) was infused at a rate of 140 micrograms/kg/min for 6 minutes and 2 mCi of thallium-201 was injected at the third minute. Stress and redistribution SPECT acquisitions were performed respectively 5-10 minutes and 4-6 hours after ATP infusion.
The incidence of side effects was 77% and chest pain was the most frequent (45%). Dyspnea occurred in 2 patients and only one patient presented transient first degree AV block. No serious or severe side effect occurred. In patients without myocardial infarction 14 of 16 patients with significant coronary artery disease had reversible perfusion defects demonstrated by ATP thallium-201 scintigraphy (sensitivity 88%) and all of 4 patients without significant coronary artery disease had normal myocardial perfusion (specificity 100%). The overall accuracy for detecting the presence of coronary artery disease was 90%. The test demonstrated an overall accuracy of 88% for detecting left anterior descending artery disease, 91% for circumflex artery disease and 80% for right coronary artery disease.
Pharmacologic stress with ATP associated with thallium-201 scintigraphy, is a safe and high accurate alternative to dipyridamole and adenosine for the diagnosis of coronary artery disease.
评估三磷酸腺苷（ATP）药物负荷试验联合铊 - 201心肌显像检测冠状动脉疾病的准确性和安全性。
我们研究了44例患者，其中男性35例，女性9例，平均年龄59±9岁。15例患者曾有心肌梗死病史。32例患者接受了冠状动脉造影，其中28例显示有冠状动脉疾病。
以140微克/千克/分钟的速率输注ATP（思特宁）6分钟，并在第3分钟注射2毫居里的铊 - 201。分别在ATP输注后5 - 10分钟和4 - 6小时进行负荷和再分布单光子发射计算机断层扫描（SPECT）采集。
副作用发生率为77%，胸痛最为常见（45%）。2例患者出现呼吸困难，仅1例患者出现短暂一度房室传导阻滞。未发生严重副作用。在无心肌梗死的患者中，16例有显著冠状动脉疾病的患者中有14例通过ATP铊 - 201心肌显像显示有可逆性灌注缺损（敏感性88%），4例无显著冠状动脉疾病的患者心肌灌注均正常（特异性100%）。检测冠状动脉疾病存在的总体准确性为90%。该试验检测左前降支疾病的总体准确性为88%，检测回旋支疾病为91%，检测右冠状动脉疾病为80%。
ATP药物负荷联合铊 - 201心肌显像对于冠状动脉疾病的诊断是一种安全且准确性高的替代双嘧达莫和腺苷的方法。
