Brown K A, Rowen M
Department of Medicine, University of Vermont College of Medicine, Burlington.
J Nucl Med. 1993 Sep;34(9):1467-71.
We sought to determine whether antianginal medications or the level of achieved stress affect the prognostic value of a normal exercise 201Tl study. We studied 261 patients with a normal exercise 201Tl study for 23 +/- 6 mo. Antianginal medications were taken at the time of stress testing in 128 patients. Peak heart rate ranged from 82 to 217 bpm; percent maximal predicted heart rate ranged from 42% to 136%. Chi-square analysis was used to determine the relationship of cardiac events to antianginal medications and stress indices. Primary cardiac events were defined as cardiac death or nonfatal myocardial infarction. Primary cardiac events occurred in six patients yielding an annual incidence of 1.2% per year. There was no significant relationship between cardiac event rate and antianginal medication use or any stress index, including Bruce stage, peak heart rate or blood pressure or percent maximal predicted heart rate achieved. The risk of cardiac death or nonfatal myocardial infarction in patients with a normal exercise 201Tl is low and is not affected by concurrent antianginal treatment or degree of stress achieved.
我们试图确定抗心绞痛药物或所达到的应激水平是否会影响正常运动铊-201心肌显像的预后价值。我们对261例运动铊-201心肌显像正常的患者进行了为期23±6个月的研究。128例患者在进行应激测试时服用了抗心绞痛药物。峰值心率范围为82至217次/分钟；最大预测心率百分比范围为42%至136%。采用卡方分析来确定心脏事件与抗心绞痛药物及应激指标之间的关系。主要心脏事件定义为心源性死亡或非致命性心肌梗死。6例患者发生了主要心脏事件，年发生率为每年1.2%。心脏事件发生率与抗心绞痛药物使用或任何应激指标（包括布鲁斯阶段、峰值心率、血压或所达到的最大预测心率百分比）之间均无显著关系。运动铊-201心肌显像正常的患者发生心源性死亡或非致命性心肌梗死的风险较低，且不受同时进行的抗心绞痛治疗或所达到的应激程度的影响。
